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Sample records for lente intra-ocular multifocal

  1. Lente intra-ocular multifocal difrativa apodizada: resultados Diffractive apodized multifocal intraocular lens: results

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    Virgilio Centurion

    2007-12-01

    Full Text Available OBJETIVO: Mostrar os resultados visuais e refracionais com lente intra-ocular multifocal difrativa apodizada. MÉTODOS: Estudo de 100 olhos de 50 pacientes com catarata, submetidos à facoemulsificação com implante bilateral de lente intra-ocular (LIO multifocal difrativa apodizada. Foi avaliada a acuidade visual binocular sem e com correção para longe e perto, a previsibilidade refracional e a freqüência de uso de óculos. RESULTADOS: A acuidade visual sem correção para longe foi de e " 20/30 em 97,56% dos olhos operados e e" J2 em 100%, sendo que 82% dos pacientes nunca usam óculos e 16% usam de forma esporádica. CONCLUSÃO: A LIO multifocal difrativa apodizada mostrou ser uma opção previsível, reproduzível e segura na correção dos vícios de refração para longe e perto durante a cirurgia da catarata, permitindo elevado índice de independência ao uso de óculos.OBJECTIVE: To show visual and refraction results using multifocal diffractive apodized intraocular lens. METHODS: The study of 100 eyes of 50 patients with cataract, submitted to phacoemulsification with bilateral implant of multifocal diffractive apodized intraocular lens (IOL. Binocular visual acuity was evaluated with and without correction for near and distance, and refraction previsibility and frequency of wearing glasses. RESULTS: Visual acuity without correction for distance was e" 20/30 in 97.56% of eyes operated on and e" J2 in 100%, of these 82% of patients never wear glasses and 16% wear glasses sporadically. CONCLUSION: Multifocal diffractive apodized IOL proved to be a foreseeable option, reproducible and safe in the correction of refraction errors for distance and near during cataract surgery, enabling a high rate of independence from the use of glasses.

  2. Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal Contrast sensitivity and stereopsis in pseudophakic patients with multifocal intraocular lens

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    Filipe de Oliveira

    2005-08-01

    Full Text Available OBJETIVO: Avaliar a sensibilidade ao contraste e a acuidade estereoscópica em pacientes pseudofácicos, que receberam implante bilateral de lente intra-ocular multifocal. MÉTODOS: Prospectivamente foram realizados testes de sensibilidade ao contraste com o uso da tabela Pelli-Robson e teste de acuidade estereoscópica com emprego do Titmus Stereo Test, em 20 pacientes com implante bilateral de lente intra-ocular multifocal Acrysof Restor®, no pós-operatório de 1 a 2 meses e sem uso de qualquer correção óptica. RESULTADOS:O teste de sensibilidade ao contraste binocular demonstrou que 6 pacientes (30% apresentaram 1,80 unid. log, 13 (65% 1,65 e 1 (5% 1,50. No teste monocular, ocorreram as seguintes respostas: 17 pacientes (85% 1,65 unid. log e 3 (15% 1,50 para o teste do olho direito. O teste do olho esquerdo mostrou que 16 pacientes (80% apresentaram 1,65 unid. log e 4 (20% 1,50. A média e o desvio-padrão da sensibilidade ao contraste testada binocularmente foi 1,69 (±0,08, ao passo que monocularmente foi 1,63 (±0,05 para OD e 1,62 (±0,06 para OE. O teste de acuidade estereoscópica revelou que 12 pacientes (60% obtiveram 40", 6 (30% 50" e 2 (10% 60", com média de 45" e desvio-padrão de ±6,88". CONCLUSÃO: A lente intra-ocular empregada no estudo, proporcionou resultados de sensibilidade ao contraste e acuidade estereoscópica compatíveis e de acordo com critérios de normalidade estabelecidos anteriormente por outros estudos em grupos de pacientes fácicos e pseudofácicos, e portanto, impacto positivo na funcionalidade visual.PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The

  3. Acuidade visual em implantes bilaterais de lentes intra-oculares monofocais e multifocais Visual acuity of bilateral implants of monofocal and multifocal intraocular lenses

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    Leonardo Akaishi

    2003-01-01

    Full Text Available OBJETIVO: Comparar a acuidade visual de longe e perto de pacientes submetidos à facoemulsificação binocular não simultânea com implante de lentes multifocais ou monofocais. MÉTODOS: Foram selecionados 20 pacientes com lentes multifocais bilaterais e outros 20 pacientes com lentes monofocais também bilaterais, com acuidade visual sem correção melhor ou igual a 0,63 (20/30, medidos separadamente, nos três primeiros meses de pós-operatório. Foi medida a acuidade visual para longe e perto com e sem correção e testes de sensibilidade ao contraste e ofuscamento. RESULTADOS: A acuidade visual sem correção para longe no grupo das monofocais teve média de 0,82 (DP± 0,16 e no grupo das multifocais, 0,94 (DP±0,12, valor de p 0,001. Os dois grupos de lentes tiveram visão com correção para longe igual a 1. No grupo das multifocais, 75% tiveram J1 e 100% tiveram J3 ou melhor sem correção. No grupo das lentes monofocais, 10% tiveram J1 e 70% tiveram J3 ou melhor sem correção. Não houve diferença significante na avaliação com o teste de sensibilidade ao contraste entre os grupos pesquisados. No teste de ofuscamento, os dois grupos tiveram redução da visão, que foi mais acentuada no grupo dos pacientes com lentes multifocais. CONCLUSÃO: A acuidade visual para longe com correção nos pacientes com implante multifocal foi semelhante a dos pacientes com implantes monofocais, embora a acuidade visual para perto no grupo em que foi implantado lente multifocal foi bastante superior ao grupo da lente monofocal. A sensibilidade ao contraste manteve-se semelhante nos dois grupos, já o ofuscamento ("glare test" no grupo multifocal foi maior que no grupo monofocal.PURPOSE: To compare distant and near visual acuity between patients submitted to bilateral nonsimultaneous facoemulsification and implantation of multifocal or monofocal intraocular lenses (IOL. METHODS: Twenty patients with bilateral multifocal IOL and 20 patients with

  4. Resultados da troca de lente intra-ocular de hidrogel opacificada

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    Salera Cristina Moreira

    2004-01-01

    Full Text Available OBJETIVO: Avaliar os resultados da explantação e substituição das lentes intra-oculares (LIO de hidrogel opacificadas. MÉTODOS: Foram analisados retrospectivamente os prontuários de 12 pacientes (15 olhos submetidos à explantação e substituição das lentes intra-oculares de hidrogel opacificadas. RESULTADOS: A opacificação das lentes intra-oculares de hidrogel causou perdas de linhas de visão em 13 olhos (86,7%. A troca das lentes intra-oculares opacificadas promoveu o ganho de linhas de visão em 11 olhos (73,3%. As complicações peroperatórias ocorreram em três olhos (20% e foram as seguintes: perda de óleo de silicone, ruptura total de zônula com perda do saco capsular e ruptura parcial de zônula. Durante a explantação das lentes intra-oculares foi necessária a realização de incisões relaxantes na borda da capsulorrexe anterior em três olhos (20% e em dois olhos (13,3% os hápticos foram cortados sendo retirada somente a zona óptica das lentes intra-oculares. CONCLUSÃO: A cirurgia para explantação e substituição das lentes intra-oculares opacificadas mostrou-se eficaz naqueles pacientes com perdas de linhas de visão (p > 0,05.

  5. Estudo comparativo do desempenho óptico de diversas lentes intra-oculares (LIO) multifocais

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    Antunes, Telma Nicole Nogueira

    2012-01-01

    A cirurgia da catarata tem vindo a evoluir ao longo dos anos, tendo sido realizado o primeiro implante de uma lente intra-ocular em 1949. Desde então, várias técnicas foram utilizadas e descontinuadas devido a insucessos. Actualmente é utilizada a técnica de facoemulsificação. Tal como a técnica cirúrgica a lente implantada também tem vindo a evoluir, tanto a nível do material como a nível de design. Com as evoluções, tanto a nível de técnica cirúrgica como a nível de forma e material das len...

  6. Lente intra-ocular opaca em diplopia intratável: relato de caso Opaque intraocular lens in intractable diplopia: case report

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    Fernanda Teixeira Krieger

    2006-08-01

    Full Text Available Diplopia intratável tem sido descrita em várias situações. Métodos convencionais como prismas e correção cirúrgica do estrabismo falham em neutralizá-la. O objetivo do trabalho é documentar o caso de uma paciente com estrabismo de longa data, cuja diplopia deteriorou-se ao longo dos anos, e não foi possível resolução com cirurgia, prisma, e oclusão com óculos e lente de contato com pupila opaca. A paciente foi então submetida à facoemulsificação com implante de lente intra-ocular opaca que atingiu o objetivo desejado.Intractable diplopia has been described in many situations but poor results are the rule with standard treatment modalities. The authors report a case of a woman with long-standing strabismus and diplopia who failed to improve following surgery, prism, and occlusive spectacles or contact lenses. Then, she was submitted to phacoemulsification and opaque intraocular lens implantation, which successfully neutralized diplopia.

  7. Aderência bacteriana in vitro a lentes intra-oculares de polimetilmetacrilato e de silicone In vitro bacterial adherence to silicone and polymetylmethacrylate intraocular lenses

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    Claudete Inês Locatelli

    2004-04-01

    Full Text Available OBJETIVOS: Verificar a aderência bacteriana a lentes intra-oculares de silicone e de polimetilmetacrilato como possível fator de risco no desenvolvimento de endoftalmite pós-operatória, utilizando-se um modelo in vitro com três microrganismos potencialmente patogênicos. MÉTODOS: As análises foram realizadas com cepas de Staphylococcus aureus ATCC 29213, Staphylococcus epidermidis (amostra clínica e Pseudomonas aeruginosa ATCC 27853 incluindo a determinação de curvas de crescimento, testes para verificação de produção de cápsula, avaliação da hidrofobicidade, testes de aderência a diferentes materiais, microscopia óptica, microscopia eletrônica de varredura e microscopia de força atômica. RESULTADOS: A produção de cápsula e a aderência das três diferentes cepas não mostraram qualquer relação com a quantidade de microrganismos; em relação às lentes intra-oculares de polimetilmetacrilato e de silicone, não houve diferença estatisticamente significativa na aderência de S. aureus e S. epidermidis; P. aeruginosa foi o microrganismo mais aderente a ambos os materiais. A microscopia eletrônica de varredura confirmou estes achados em relação à aderência, ao peso que a microscopia de força atômica evidenciou a produção de biofilme pelas cepas de S. aureus, S. epidermidis e P. aeruginosa. CONCLUSÕES: Constatou-se, in vitro, que os materiais analisados não diferiram com relação à taxa de aderência bacteriana, porém, P. aeruginosa apresentou maior eficiência de adesão entre as bactérias testadas. Todas as cepas produziram biofilme. Silicone foi o material mais hidrofóbico, quando comparado ao polimetilmetacrilato.PURPOSE: To evaluate bacterial adherence to silicone and polymetylmethacrylate (PMMA intraocular lenses as a risk factor for postsurgery endophthalmitis by using an in vitro model with three potentially pathogenic microorganisms. METHODS: In vitro experiments were carried out with the

  8. Comparison between OPD-scan results and contrast sensitivity of three intraocular lenses: spheric AcrySof SN60AT, aspheric AcrySof SN60WF and multifocal AcrySof Restor lens Estudo comparativo da análise de frente de onda e sensibilidade ao contraste entre as lentes intra-oculares multifocal AcrySof Restor SN60D3, monofocal AcrySof SN60WF asférica e a monofocal SN60AT esférica

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    Celso Takashi Nakano

    2009-08-01

    ção com implantes de lentes intraoculares AcrySof SN60D3 multifocal, AcrySof SN60WF monofocal asférica e AcrySof SA60AT monofocal esférica. Métodos: Trinta e dois olhos com a lente intraocular multifocal, 32 olhos com a lente intraocular monofocal asférica e 32 olhos com a lente intraocular monofocal esférica. A avaliação oftalmológica foi realizada no primeiro, terceiro, sétimo, e nonagésimo dia pós-operatório. Todos os exames foram padronizados, realizada por um único examinador sob condições controladas de luminosidade fotópicas estabelecidas em 85 cd/m², medida por meio de tabelas de ETDRS, sensibilidade ao contraste e análise de aberrometria com OPD-Scan. Resultados: As médias de aberração total foi superior no grupo SN60AT (KW = 9.42; p=0.009 quando comparada com o grupo SN60D3 (p=0.016 e o grupo SN60WF (p=0.0047. O grupo SN60AT (KW = 16.20; p=0.0003 apresentou superioridade nas medias de aberração esférica comparada com o grupo SN60WF (p=0.00046 e o grupo SN60D3 (p=0.0014. Nenhuma diferença significante foi encontrada na acuidade visual para longe com e sem correção óptica com a tabela de ETDRS a 100% e 9% de contraste. O grupo SN60D3 comparada a SN60AT (p=0.016 apresentou baixa sensibilidade ao contraste em condições fotópicas com diferença estatística a 6.0 cpg (KW = 7.84; p=0.0199, mas sem diferença estatística entre os grupos SN60WF e SN60AT (p=0.91 e entre os grupos SN60WF e SN60D3 (p=0.051. O grupo SN60D3 apresentou baixa sensibilidade ao contraste em condições mesópicas (KW = 10.79; p=0,0045 a 6cpg quando comparada com o grupos SN60AT (p=0.011 e SN60WF (p=0.007. Conclusão: As lentes intraoculares multifocais e asféricas apresentaram menos aberração esférica quando comparadas à lente intraocular esférica, além da prevista multifocalidade sem correção para longe e perto. Entretanto, o grupo multifocal apresentou baixa sensibilidade ao contraste.

  9. Aderência in vitro do Staphylococcus epidermidis e da Pseudomonas alcaligenes em lentes intra-oculares In vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to intraocular lenses

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    Patrícia Ioschpe Gus

    2006-06-01

    Full Text Available OBJETIVO: Quantificar e comparar a aderência in vitro das bactérias Staphylococcus epidermidis e Pseudomonas alcaligenes em diferentes tipos de lentes intra-oculares (LIOs. MÉTODOS: Quatorze lentes intra-oculares foram usadas no experimento. Quatro de polimetilmetacrilato (PMMA, quatro de silicone, quatro de hidrogel e duas de acrílico. Oito lentes intra-oculares foram colocadas em oito tubos de ensaio contendo 4 ml de suspensão de Pseudomonas alcaligenes, e seis lentes intra-oculares foram colocadas em seis tubos de ensaio contendo 4 ml de suspensão de Staphylococcus epidermidis. A concentração do caldo utilizada para o teste de aderência foi de 10(8 unidades formadoras de colônias por mililitro (CFU/mL que corresponde a 0,5 na escala de McFarland. As lentes foram incubadas a 37° por duas horas. Após, foram removidas dos caldos e enxaguadas em água destilada estéril por duas vezes. As lentes foram cultivadas em placas de ágar-sangue a 35-37° e evaliadas a cada 24h por um período de 72h. Nas amostras que tiveram crescimento bacteriano, foram contadas as colônias utilizando os métodos convencionais de laboratório. Todos os ensaios foram executados em duplicata. RESULTADOS: A aderência do Staphylococcus epidermidis nas lentes de PMMA foi menor se comparada com as de silicone e de hidrogel. A aderência daPseudomonas alcaligenes nas lentes de hidrogel foi menor se comparada com as de silicone, PMMA e acrílico. CONCLUSÃO: Os resultados sugerem que a aderência do Staphylococcus epidermidis e da Pseudomonas alcaligenes nas lentes intra-oculares é influenciada pelo tipo de material da lente e pela espécie do microorganismo. A aderência bacteriana pode ter papel importante na patogenicidade da endoftalmite pós-cirurgia de catarata.PURPOSE: To quantify and compare the in vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to different intraocular lenses (IOLs. METHODS: Fourteen intraocular lenses were

  10. Facoemulsificação, vitrectomia via pars plana e implante de lente intra-ocular em olhos com retinopatia diabética proliferativa Phacoemulsification, pars plana vitrectomy and intraocular lens implant in eyes with proliferative diabetic retinopathy

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    Armando Belfort Mattos

    2004-06-01

    Full Text Available OBJETIVO: Avaliar a viabilidade da técnica de facoemulsificação para a extração da catarata com implante de lente intra-ocular combinada à vitrectomia via pars plana em olhos com retinopatia diabética proliferativa, em um único procedimento cirúrgico. MÉTODOS: Foram revisados os prontuários de 47 pacientes (53 olhos com retinopatia diabética proliferativa e catarata que foram submetidos ao procedimento combinado de vitrectomia via pars plana, facoemulsificação e implante de lente intra-ocular no mesmo ato cirúrgico, entre janeiro de 1991 e setembro de 1998 no Bascom Palmer Eye Institute, hospital de olhos filiado à Universidade de Miami. O estudo foi realizado em conjunto com a Universidade Federal de São Paulo. Participaram do estudo 43 olhos de 40 pacientes. RESULTADOS: O tempo de seguimento variou de três a 60 meses com média de 20 meses. A idade dos pacientes variou de 37 a 77 anos com média de 59 anos. A acuidade visual melhorou duas linhas ou mais em relação ao pré-operatório em 26 (60,4% olhos, permaneceu a mesma em 9 (20,9% e piorou em 8 (18,6%. Em (23,2% 10 olhos a acuidade visual aumentou para 20/40. O teste estatístico chamado de "teste do sinal" mostrou-se estatisticamente significante na melhora da acuidade visual final. A complicação mais observada foi a hemorragia vítrea recorrente, ocorrendo em 12 (27,9% olhos, seguida pela inflamação transitória da câmara anterior em 9 olhos (20,9%. Complicações intra-operatórias relacionadas à extração do cristalino foram raras. No pós-operatório observaram-se captura da lente intra-ocular em 2 (4,6 % olhos e lente intra-ocular subluxada em 1 (2,3% olho. CONCLUSÕES: A cirurgia combinada de facoemulsificação, implante de lente intra-ocular e vitrectomia via pars plana em olhos com retinopatia diabética é procedimento bem tolerado e geralmente apresenta bons resultados com relação à acuidade visual. Um único procedimento para remover a catarata e

  11. Análise da fórmula SRK/T no cálculo de lente intra-ocular em cães portadores de catarata Analysis of the SRK/T formula for calculation of intra-ocular lens in dogs carrying cataract

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    T.P. Peixoto

    2008-12-01

    Full Text Available Foram utilizados 20 cães de raças e idades variadas, machos e fêmeas, portadores de catarata e não diabéticos, os quais foram submetidos ao exame oftálmico. Posteriormente, realizaram-se mensurações oculares empregando-se um ecobiômetro ultra-sônico (ultra-sonografia modo-A para o cálculo do poder dióptrico da lente intra-ocular por meio da fórmula SRK/T. O comprimento axial médio foi de 19,94±1,12mm. Todos os animais foram submetidos à facoemulsificação extracapsular. A lente calculada foi implantada no transoperatório da cirurgia de catarata, obtendo-se média de 37,33±3,05D. A avaliação pós-cirúrgica do erro refracional aos 60 dias de pós-operatório, pela retinoscopia, com a utilização da esquiascopia, foi de 5,57±1,59D. A fórmula SRK/T não ofereceu bons resultados.Twenty males and females non-diabetic dogs of different breeds and ages underwent ophthalmic examination because they presented catarats. Ocular measurements were performed by echobiometry (A-scan ultrasound for intraocular lens power calculation using the SRK/T formula. The obtained mean axial length was 19.94±1.12mm. All animals were submitted to extracapsular phacoemulsification; the mean intraocular lens power implanted was 37.33±3.05. At 60 days postoperative, the refractional error assessed via retinoscopy was 5.57±1.59 D. The SRK/T formula did not offer good results.

  12. Resultados preliminares do implante de lente intra-ocular fácica artisan para correção de miopia Preliminary results of artisan phakic intraocular lens implantation to correct myopia

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    Leonardo Akaishi

    2007-06-01

    Full Text Available OBJETIVOS: Avaliar os resultados preliminares quanto à eficácia, estabilidade e segurança da lente intra-ocular de câmara anterior Artisan em olhos fácicos para correção de miopia. MÉTODOS: Foi analisado retrospectivamente o resultado de 34 olhos fácicos que receberam o implante de lente intra-ocular Artisan para correção de miopia. Os parâmetros avaliados foram: contagem endotelial pré e pós-operatória, acuidade visual sem correção pré e pós-operatória, melhor acuidade visual com correção pré e pós-operatória, equivalente esférico pré e pós-operatório, ganho e perda de linhas de visão e complicações. RESULTADOS: Dezoito pacientes (34 olhos foram incluídos neste estudo. Quatorze eram do sexo feminino (77,8% e 4 do sexo masculino. A idade média dos pacientes era de 30 anos (DP ± 7,3, variando de 21 a 46 anos. O período médio de seguimento foi de 8,5 meses (DP ± 3,6. A média de perda endotelial foi de 4,75% em 6 meses. A acuidade visual sem correção pré-operatória era de 0,02 (20/800 variando de 0,01 a 0,13. O equivalente esférico médio pré-operatório na refração dinâmica era de -13,25 D, variando de -5,75 D a -19,75 D. No último seguimento a acuidade visual sem correção era de 0,64 (20/32 variando de 0,33 a 1,00. O equivalente esférico médio na refração dinâmica era de -1,18 D (DP ± 0,92 variando de + 0,25 a -3,0. Entre as complicações observadas em nosso estudo 1 (3,4% paciente apresentou deslocamento da lente por trauma necessitando de uma segunda intervenção para reposicionamento. CONCLUSÃO: O uso de lente fácica de câmara anterior Artisan para correção de miopia no presente estudo se mostrou seguro, eficaz e com boa previsibilidade. No entanto, estudo prospectivo com maior número de casos e maior seguimento é necessário para determinar a segurança do procedimento a longo prazo.PURPOSE: To observe the preliminary results based on the efficacy, stability and safety of

  13. Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy Comparação entre lentes intra-oculares de PMMA, lentes dobráveis de silicone e lentes acrílicas hidrofóbicas dobráveis em cirurgias combinadas de facoemulsificação e trabeculectomia

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    Ernani Serpa Junior

    2005-02-01

    Full Text Available PURPOSE: To compare the postoperative results of phacotrabeculectomy with implantation of PMMA, foldable silicone or foldable hydrofobic acrylic intraocular lens (IOL. SETTING: Glaucoma unit, The Royal Liverpool University Hospital, Liverpool, United Kingdom. METHODS: We studied a total of 124 eyes of three consecutive groups of patients with glaucoma and cataract that underwent phacotrabeculectomy with implantation of a PMMA (30 eyes, a foldable silicone (57 eyes or a foldable acrylic (37 eyes IOL. Postoperative Snellen visual acuity and intraocular pressure (IOP, and early and late complications were assessed. All data were analyzed by means of c² test, Fisher's exact test, ANOVA/MANOVA tests or a combination whenever appropriate. RESULTS: In all three groups the early and late mean postoperative IOPs were significantly lower than the preoperative ones (p25 mmHg and hypotony (IOPOBJETIVO: Comparar os resultados pós-operatórios de facotrabeculectomias com implante de lentes intra-oculares de PMMA, dobráveis de silicone e acrílicas hidrofóbicas dobráveis. MÉTODOS: Estudo comparativo retrospectivo, realizado no Departamento de Glaucoma da "St. Paul's Eye Unit - The Royal Liverpool University Hospital", em Liverpool, Inglaterra, onde foram estudados um total de 124 olhos de três grupos consecutivos de pacientes com glaucoma e catarata que foram submetidos à cirurgia de facotrabeculectomia com implante de lentes intra-oculares (LIO de PMMA (30 olhos, dobráveis de silicone (57 olhos e acrílicas hidrofóbicas dobráveis (37 olhos. Foram registradas a visão e pressão intra-ocular (PIO pré e pós-operatória, assim como as complicações pós-operatórias precoces e tardias. Todos os dados foram analisados utilizando-se o teste c², teste exato de Fisher, teste de ANOVA/MANOVA ou uma combinação deles quando necessário. RESULTADOS: Nos três grupos as PIOs pós-operatórias precoces e tardias foram significativamente inferiores

  14. Implante intra-ocular de lentes dobráveis "piggyback" em paciente portador de catarata congênita no primeiro ano de vida: relato de caso Piggyback foldable intraocular lens implant in patient with congenital cataract in the first year of life: case report

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    Leonardo Akaishi

    2004-12-01

    Full Text Available No presente relato os autores descrevem um caso de catarata congênita unilateral tratada cirurgicamente com implante intra-ocular de lentes dobráveis "piggyback", ainda não descrito na literatura nacional. São analisadas as diferenças e semelhanças com outros casos descritos na literatura.The authors report a case of congenital cataract, which was treated with piggyback foldable intraocular lens implant, not described in the Brazilian literature. The differences and similarities are analyzed with other reported cases in the literature.

  15. Qualidade de vida de pacientes pseudofácicos submetidos à cirurgia de catarata com implante de lente intra-ocular acomodativa Quality of life of pseudophakic patients with accommodative intraocular lens implant

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    Filipe de Oliveira

    2004-06-01

    Full Text Available OBJETIVO: Avaliar a função visual e satisfação dos pacientes submetidos à cirurgia de catarata com implante de lente intra-ocular acomodativa e o impacto na sua qualidade de vida. MÉTODOS: Retrospectivamente, foram avaliados questionários aplicados após um ano da cirurgia de 22 pacientes que foram incluídos num estudo clínico para avaliar segurança e eficácia de uma lente intra-ocular de silicone de câmara posterior designada para corrigir visão para longe e perto. RESULTADOS: Do total dos pacientes operados, 16 (73% eram bilaterais e 6 (27% unilaterais, com idade média de 70,2 anos. Dos pacientes com implante unilateral, 5 (83,3% declararam melhora acentuada da visão e 1 (16,7% referiu máxima melhora. Quanto ao nível de satisfação, 5 (83,3% ficaram satisfeitos e 1 (16,7% muito satisfeito com o resultado cirúrgico. A visão noturna foi declarada como sem dificuldade por 3 (50,0%, pouca dificuldade por 2 (33,3% e dificuldade moderada por 1 (16,7%. No grupo bilateral, 7 (43,8% consideraram excelente a qualidade da visão para perto, 7 (43,8% muito boa, 1 (6,2% adequada e 1 (6,2% ruim. A visão intermediária foi classificada como excelente por 6 (37,5%, muito boa por 9 (56,3% e adequada por 1 (6,2%. A qualidade da visão para longe foi considerada excelente por 9 (56,3%, muito boa por 3 (43,8%, adequada por 2 (12,5% e não muito boa por 2 (12,5%. Em relação à visão noturna 9 (56,3% declararam não ter dificuldade alguma, 5 (31,2% pouca dificuldade e 2 (12,5% dificuldade moderada. CONCLUSÕES: Considerando a propriedade óptica da LIO, a maioria dos pacientes apresentou uma melhora considerável da função visual, sem a necessidade de correção óptica, e, portanto, com impacto positivo na qualidade de vida.PURPOSE: To evaluate the visual function and satisfaction of patients who underwent cataract surgery and were implanted with an accommodative intraocular lens and the impact in their quality of life. METHODS

  16. Incidência de opacificação de cápsula posterior em pacientes submetidos à facoemulsificação e implante de lentes intra-oculares acrílicas hidrofílicas expansíveis Incidence of posterior capsule opacification in patients submitted to phacoemulsification and expandable acrylic intraocular lens implantation

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    Hilton Arcoverde Gonçalves de Medeiros

    2006-06-01

    Full Text Available OBJETIVO: Avaliar prospectivamente os resultados das lentes intra-oculares de polímeros expansíveis implantadas em pacientes submetidos à facoemulsificação, quanto à incidência de opacificação de cápsula posterior, levando em consideração a biocompatibilidade das lentes expansíveis. MÉTODOS: O grupo de estudo foi composto por 830 pacientes, 1.200 olhos, que foram submetidos a facoemulsificação, utilizando a mesma técnica, variando-se apenas o diâmetro da capsulorrexe, pelo mesmo cirurgião, no período de 1998 a 2002, com implante de lente intra-ocular hidrofílica expansível. O acompanhamento médio foi de 2,4 anos, variando de seis meses a quatro anos. RESULTADOS: O número total de opacificação de cápsula posterior foi de 54 casos. CONCLUSÃO: A incidência de opacificação de cápsula posterior encontrada no grupo foi de 4,6%.PURPOSE: To evaluate prospectively the results of expandable acrylic intraocular lenses in patients submitted to phacoemulsification as regard posterior capsule opacification. METHODS: The study group consisted of 830 patients, 1,200 eyes that underwent phacoemulsification from 1998 to 2002, by the same surgeon, using the same technique but with different diameters of capsulorrhexis, with expandable hydrophilic acrylic intraocular lens implantation. The mean follow-up was 2.4 years, ranging from 6 months to 4 years. RESULTS: The total number of posterior capsule opacification was 54 cases. CONCLUSIONS: The incidence of posterior capsule opacification was 4.6% in these patients.

  17. Comparação entre os resultados pós-operatórios de pacientes submetidos ao procedimento tríplice e transplante de córnea combinado a fixação secundária de lente intra-ocular Comparison between the postoperative results of triple procedure and combined penetrating keratoplasty/ transsclerally sutured posterior chamber lens implantation

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    Daniela Maggioni Pereira Leão

    2006-08-01

    Full Text Available OBJETIVO: Comparar os resultados pós-operatórios de 2 grupos de pacientes submetidos a transplante de córnea com técnicas e tempo cirúrgico diferentes, em relação à abordagem do cristalino e/ou lente intra-ocular. MÉTODOS: Neste estudo retrospectivo foram analisados 37 olhos de pacientes divididos em 2 grupos: extração de catarata, implante de lentes intra-oculares (LIO e transplante de córnea no mesmo tempo cirúrgico - grupo 1 (G1 e extração de catarata sem implante de lentes intra-oculares no primeiro tempo cirúrgico e fixação secundária de lentes intra-oculares associada a transplante de córnea no segundo tempo cirúrgico - grupo 2 (G2. As variáveis estudadas foram: acuidade visual, pressão intra-ocular (PIO, astigmatismo refracional, astigmatismo ceratométrico e complicações pós-operatórias. RESULTADOS: Foi observado melhora da acuidade visual nos 2 grupos (G1 pPURPOSE: To compare the outcomes of two surgical techniques of penetrating keratoplasty with different surgical time, regarding the crystalline and the intraocular lens. METHODS: This retrospective study included 37 patients' eyes divided into 2 groups: extracapsular cataract extraction, posterior chamber intraocular lens implantation and penetrating keratoplasty (Group 1, G1 and transscleral fixation of posterior chamber lens and penetrating keratoplasty (Group 2, G2. The following parameters were recorded: visual acuity, intraocular pressure, refractive astigmatism, complication and keratometric astigmatism. RESULTS: Visual acuity improved in the two groups (G1 p<0.001 and G2 p=0.008. In G2 a significant change for the worse of intraocular pressure outcome was observed when compared with the other group (p=0.014. Regarding refractive and keratometric astigmatism no significant differences between the groups were found. The follow-up was 11 months. CONCLUSION: The most important negative prognostic factor affecting visual acuity was the postkeratoplasty

  18. Estudo prospectivo comparativo de duas técnicas cirúrgicas de extração extra-capsular planejada de catarata com implante de lente intra-ocular: incisão limbar e incisão escleral tunelizada Prospective comparative study of two techniques of planned extracapsular cataract extraction: limbal incision and scleral tunnel incision

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    Lincoln Lemes Freitas

    2001-06-01

    Full Text Available Introdução: A catarata é responsável por 50% da cegueira no mundo, com um número estimado de 15 milhões de casos que necessitariam cirurgia. Diferentes técnicas para a extração extra-capsular da catarata com implante de lente intra-ocular foram propostas. Objetivo: Comparar as técnicas para extração extra-capsular de catarata com implante de lente intra-ocular utilizando incisão limbar e incisão escleral tunelizada. Métodos: Foram avaliados, prospectivamente, 59 olhos de 54 pacientes com acompanhamento pós-operatório de 6 meses. Aleatoriamente, os pacientes foram divididos em dois grupos. No Grupo I (n=30, a técnica realizada foi a de extração extra-capsular com implante de lente intra-ocular com incisão limbar e no Grupo II (n=29, com incisão tunelizada. Foram avaliadas as medidas da acuidade visual corrigida, inflamação intra-ocular (células e "flare", tempo de cirurgia, microscopia especular, astigmatismo ceratométrico induzido e paquimetria. Resultados: O tempo de cirurgia, a perda de células endoteliais e o astigmatismo ceratométrico induzido foram estatisticamente maiores no Grupo I que no Grupo II. Não houve diferença estatisticamente significante entre os grupos I e II quanto à acuidade visual, a quantidade de células na câmara anterior, a quantidade de "flare" na câmara anterior e paquimetria. Conclusão: A técnica para extração extra-capsular de catarata com incisão tunelizada apresentou vantagens quanto ao tempo de cirurgia, perda de células endoteliais e astigmatismo induzido em relação à técnica com incisão limbar. Os passos utilizados nessa técnica visam facilitar a extração da catarata, além de treinar o cirurgião para uma transição mais segura para facoemulsificação, sem aumentar o custo da cirurgia.Purpose: Cataract is the main cause of blindness throughout the world, affecting more than 15 million people worldwide. There are different techniques for extracapsular cataract

  19. Comparação da análise da frente de onda e da sensibilidade ao contraste em olhos pseudofácicos com implante de lentes intra-oculares esférica e asférica Wavefront analysis and contrast sensitivity comparison between spheric and aspheric intraocular lenses

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    Wilson Takashi Hida

    2008-06-01

    Full Text Available OBJETIVO: Comparar a análise da frente de onda e a sensibilidade de contraste pós-operatórias em pacientes submetidos à facoemulsificação com implante de lentes intra-oculares esféricas num olho e asféricas no olho contralateral. MÉTODOS: Este estudo prospectivo comparativo, randomizado, duplo-cego, incluiu 32 olhos de 16 pacientes. Uma avaliação oftalmológica completa foi realizada durante as visitas antes e depois da cirurgia (no primeiro, terceiro, sétimo, e nonagésimo dias pós-cirúrgicos, que incluiu acuidade visual, teste de sensibilidade ao contraste, aberrometria. Todos exames (menos aberrometr=ia foram feitos monocularmente com pupilas não dilatadas. Os pacientes foram submetidos a facectomia ultra-sônica convencional com implante de uma lente asférica SN60WF num olho e esférica SN60ATno outro. RESULTADOS: A acuidade visual média com a melhor correção foi -0,146 LogMAR no grupo da lente intra-ocular esférica, e -0.165 logMAR no grupo da lente intra-ocular asférica sob condições fotópicas, -0,003 LogMAR sob condições mesópicas. A sensibilidade ao contraste foi semelhante em ambos os grupos tanto em condições fotópicas e mesópicas. Em relação às aberrações ópticas ocorreu uma diferença significativa nas aberrações totais (1,09 ± 0,56 no grupo asférico e 1,52 ± 1,19 no grupo esférico e no componente esférico das aberrações de alta ordem(0,422 ± 0,202 no grupo asférico e 0,124 ± 0,087 no grupo esférico. CONCLUSÃO: As duas lentes intra-oculares promoveram uma excelente visão em situações de alto contraste, e os olhos implantados com a lente asférica tiveram menos aberrações totais e esféricas que aqueles implantados com a lente esférica.PURPOSE: Compare the wavefront and contrast sensitivity of bilateral pseudophakic patients with aspheric in one eye and spheric intraocular lenses in the other. METHODS: This prospective, comparative, randomized study, double masked, included 32

  20. Bloqueio extraconal para facectomia com implante de lente intra-ocular: influência do fentanil associado ao anestésico local na qualidade do bloqueio e na analgesia pós-operatória Bloqueo extraconal para facectomia con implantación de lente intra-ocular: influencia del fentanil asociado al anestésico local en la calidad del bloqueo y en la analgesia pos-operatoria Extraconal block for cataract extraction surgery with implantation of intraocular lens: contribution of fentanyl associated to local anesthetics for quality of block and postoperative analgesia

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    Daniel Espada Lahoz

    2003-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A anestesia locorregional para cirurgias oftalmológicas oferece vantagens, como: mínimas alterações fisiológicas, anestesia completa, bloqueio dos reflexos oculares, pequena incidência de náuseas e vômitos, menor tempo de recuperação e analgesia pós-operatória. A preocupação constante com a qualidade do bloqueio, assim como da abordagem da analgesia pós-operatória deve ficar sob a responsabilidade do anestesiologista. O objetivo deste estudo foi avaliar se o fentanil contribui na qualidade do bloqueio extraconal e na analgesia pós-operatória de facectomias com implante de lente intra-ocular. MÉTODO: Estudou-se a associação do fentanil e bupivacaína a 0,75% na qualidade do bloqueio ocular e na analgesia pós-operatória em 164 pacientes submetidos a facectomia com implante de lente intra-ocular (técnica extracapsular, de ambos os sexos com homogeneidade de parâmetros antropométricos, olho operado, classificação do estado físico (ASA e índice de risco cardíaco de Goldman. Os pacientes foram distribuídos em dois grupos (82 pacientes em cada grupo por sorteio de forma aleatória, com e sem fentanil. Avaliou-se a qualidade do bloqueio por: aparecimento da dor no per-operatório, manutenção de movimentação das pálpebras ou do globo ocular, persistência do reflexo de Bell, número de bloqueios realizados para a obtenção de condições cirúrgicas e avaliação do bloqueio pelo cirurgião. A analgesia pós-operatória foi avaliada pela necessidade de complementação analgésica pelo paciente. RESULTADOS: Fentanil associado à solução anestésica no bloqueio extraconal aumentou significativamente o bloqueio do músculo reto medial (com fentanil - 17,1%, sem fentanil - 32,9% e diminuiu o consumo de analgésicos no período pós-operatório (uso de analgésicos com fentanil - 20,7%, não uso de analgésicos com fentanil - 41,5%. CONCLUSÕES: Nas condições deste estudo o fentanil

  1. Necrotizing nocardial scleritis after combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation: a case report and review of the literature Esclerite necrosante por Nocardia após ceratoplastia penetrante e facoemulsificação com implante de lente intra-ocular: caso clínico e revisão de literatura

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    Jerome Charles Ramos-Esteban

    2007-03-01

    Full Text Available We report the history and clinical presentation of an 88-year-old female with Fuchs dystrophy who developed an acute anterior necrotizing scleritis in her left eye 23 months after an uncomplicated combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation which progressed to slceral perforation with uveal prolapses. The patient underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis. Surgical specimens of the area of scleral perforation were sent for histology and microbiologic studies. Analysis of surgical specimens revealed the presence of culture-proven Nocardia asteroides as a causative agent for the patient's scleral perforation. Results of her systemic autoimmune work-up were not conclusive. Successful treatment with tectonic scleral reinforcement with donor corneal tissue and preserved pericardium, oral and topical trimethoprim-sulfamethoxazole and topical amikacin salvaged the globe and increased vision. The patient's final best-corrected visual acuity sixteen months after her last operation remains 20/70. Prompt surgical intervention with submission of appropriate specimens for pathological diagnosis and microbiology, along with consultation with rheumatologic and infectious disease specialists, are mandatory to minimize visual loss in cases of suspected infectious necrotizing scleritis.Relato de caso de esclerite necrosante aguda, evoluindo para perfuração escleral com prolapso uveal, 23 meses após procedimento de ceratoplastia penetrante e facoemulsificação com implante de lente intra-ocular no olho esquerdo sem intercorrências.A paciente foi submetida à avaliação completa auto-imune para esclerite. Biópsia da área de perfuração escleral foi encaminhada para avaliação patológica e microbiológica. Análise de material cirúrgico revelou presença de cultura proveniente de Nocardia asteroides como agente causal da perfuração escleral. Resultados de

  2. Comparison between OPD-Scan results and visual outcomes of monofocal and multifocal intraocular lenses Comparação dos resultados do OPD-Scan e performance visual das lentes intraoculares monofocal e multifocal

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    Wilson Takashi Hida

    2009-08-01

    Full Text Available PURPOSE: To compare the visual outcome, contrast sensitivity and wavefront analysis of patients that underwent cataract surgery and implantation of AcrySof SN60D3 multifocal intraocular lens with those who received the AcrySof SN60AT monofocal IOL. METHODS: This was a prospective clinical trial of forty eyes that received the multifocal IOL and thirty-two eyes that received the monofocal IOL after phacoemulsification. RESULTS: Values for total and spherical aberrations in the multifocal group were statistically lower than in the monofocal group. In the monofocal group, 75% achieved uncorrected intermediate visual acuities between Jaeger 1 and 6. In the multifocal group, 75% of the eyes achieved more than Jaeger 6. At least 87.5% of the multifocal group and 6.3% of the monofocal group achieved monocular uncorrected near acuity of 20/30 (J2, N5 or better. And 90.0% of the eyes in the multifocal group and 37.5% in the monofocal group achieved an uncorrected near acuity of 20/40 (J3, N6 or better. The mean spherical error was 0.11 D in the multifocal group and -0.18 D in the monofocal group (p=0.0379. The SN60D3 group compared to SN60AT group had low contrast sensitivity (log units with statistically significant differences in 6.0 cpd in photopic conditions (p=0.014 and the SN60D3 group compared to SN60AT group had higher contrast sensitivity (log units under mesopic conditions (p=0.044. CONCLUSION: The multifocal IOLs induced less spherical aberration than monofocal IOLs and predictably good uncorrected distance and uncorrected near acuities. However, contrast sensitivity was lower in the multifocal group.OBJETIVO: Comparar a performance visual, sensibilidade ao contraste e de wavefront com OPD-Scan em pacientes submetidos a cirurgia de facoemulsificação com implante de lente intraocular AcrySof SN60D3 multifocal e AcrySof SA60AT monofocal. MÉTODOS: Quarenta olhos com a lente intraocular multifocal e trinta e dois olhos com a lente intraocular

  3. Desempenho visual após implante de uma lente intraocular asférica multifocal difrativa Visual performance after implantation of an aspheric multifocal diffractive intraocular lens

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    Leonardo Akaishi

    2010-08-01

    Full Text Available OBJETIVO: Avaliar a acuidade visual a distancia, intermediária e perto após o implante de uma lente intraocular (LIO asférica multifocal difrativa AcrySof® ReSTOR® SN6AD1. MÉTODOS: Estudo prospectivo de 50 pacientes com catarata submetidos à facoemulsificação e implante de LIO AcrySof® ReSTOR®. Foram avaliados acuidade visual sem correção (AVSC, acuidade visual com correção (AVCC para longe, acuidade visual para perto corrigida para longe (AVPC e acuidade visual intermediária corrigida para longe (AVIC. Um questionário de satisfação e fenômenos visuais foi administrado ao final do estudo. RESULTADO: Após três meses de cirurgia, a média das acuidades (logMAR era: AVSC, 0,05 ± 0,07; AVCC, 0,00 ± 0,01; AVPC, 0,00 ± 0,0, e AVIC, 0,15 ± 0,05. A AVCC e AVPC era de 20/25 ou melhor em todos os pacientes, sendo a AVIC J3 ou melhor em 83% dos pacientes. Pacientes relataram excelente desempenho visual nas questões relacionadas a atividades para distância, intermediário, e perto com pouca ou nenhuma dificuldade. Nenhum paciente relatou halos ou 'glare' severos, sendo os mesmos caracterizados entre nenhum a moderado. CONCLUSÃO: A LIO asférica AcrySof® ReSTOR® SN6AD1 mostrou excelentes resultados na visão para longe, perto e intermediário, além de apresentar uma baixa incidência de fenômenos visuais.PURPOSE: To evaluate distance, intermediate, and near vision after aspheric multifocal diffractive AcrySof® ReSTOR® SN6AD1 intraocular lens (IOL implantation. METHODS: Prospective study of 50 patients with cataract that had phacoemulsification and AcrySof® ReSTOR® IOL implantation. Uncorrected distance vision acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA were measured postoperatively. A patient-satisfaction and visual phenomena questionnaire was administered at the end of the study. RESULTS: Three months

  4. Biomicroscopia ultra-sônica na avaliação da posição das lentes intra-oculares em uma técnica de fixação escleral Ultrasound biomicroscopy in the assessment of the intraocular lenses positioning in a transscleral fixation technique

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    Raul de Camargo Vianna Filho

    2000-10-01

    Full Text Available Objetivo: Avaliar pela biomicrospia ultra-sônica (UBM o posicionamento, em relação ao sulco ciliar, das alças de lentes intra-oculares (LIO, em uma técnica de fixação escleral, avaliando-se também se dois pontos de fixação são suficientes para que não haja inclinação da parte óptica. Métodos: Dezesseis olhos afácicos foram submetidos a implante LIO por uma mesma técnica de fixação escleral, realizados por um mesmo cirurgião. Um mês após a cirurgia, o posicionamento das alças das LIO foram avaliados pelo UBM, assim como distâncias entre as LIO e córnea. Os resultados foram submetidos a testes estatísticos. Resultados: Das 32 alças fixadas à esclera, oito estavam localizadas no sulco ciliar e 24 fora deste. Não houve diferença estatística nas distâncias entre LIO e córnea para alças posicionadas no sulco ciliar quando comparadas àquelas localizadas fora do sulco. Isto sugere que, além da distância ao limbo que se transfixa a esclera, outros fatores devem estar associados ao posicionamento da alça no sulco ciliar. As medidas LIO -- córnea realizadas na periferia das LIO às 3, 6, 9, e 12 horas foram semelhantes, mostrando que dois pontos de fixação são suficientes para que a LIO não fique inclinada. Conclusões: Outros fatores (por exemplo o ângulo de abertura do corpo ciliar, além da distância ao limbo na qual se transfixa a esclera, são importantes para o posicionamento das alças no sulco ciliar. Dois pontos de fixação são suficientes para que a LIO não apresente inclinação dentro do olho.Purpose: To assess, through ultrasound biomicroscopy (UBM, the positioning of the intraocular lenses (IOL haptics as related to the ciliary sulcus by using a scleral fixation technique; and to evaluate, as well, if two fixation points are sufficient to avoid tilting of the lenses. Methods: Sixteen aphakic eyes underwent an IOL implan-tation by means of the same scleral fixation technique, performed by the

  5. Calidad visual en pacientes con lente intraocular multifocal modelo OcuFlex operados de catarata The quality of vision in patients operated on from cataract and implanted with OcuFlex multifocal intraocular lenses

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    Eneida Pérez Candelaria

    2010-01-01

    Full Text Available OBJETIVO: Describir la calidad visual en 8 pacientes operados de catarata bilateral con la técnica de Faco-chop e implante de lente intraocular multifocal modelo OcuFlex, en el ICO "Ramón Pando Ferrer", desde septiembre 2007 a febrero 2008. MÉTODOS: Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo para lo cual se analizaron variables como equivalente esférico, sensibilidad al contraste en el preoperatorio y posoperatorio; fenómenos visuales, centrado y localización del lente intraocular, así como el estado de satisfacción subjetiva de los pacientes. Se utilizó la estadística descriptiva con ayuda del sistema Microsoft Excel y Word 2003, para Windows XP. RESULTADOS: El equivalente esférico medio posoperatorio fue -0,59 tanto para frecuencias bajas como medias, en visión binocular la sensibilidad al contraste media fue de 1,12 unid.log en el preoperatorio y de 1,74 unid.log. en el posoperatorio. Por biomicroscopia con lámpara de hendidura en el 100 % de los casos el lente intraocular estaba centrado y por biomicroscopia ultrasónica el 93,75 % se encontraba en el saco capsular. Ningún paciente refirió la presencia de glare y solamente uno (12,5 % reportó visión de halos nocturnos. La totalidad de los pacientes se manifestaron satisfechos. CONCLUSIONES: Los lentes multifocales disminuyen la dependencia de las gafas después de la cirugía de catarata, razón por la que constituye una buena opción en la recuperación de la función visual óptima.OBJECTIVE: To describe the quality of vision in 8 patients, who were operated on from bilateral cataract using Phaco-chop technique and implanted with Ocuflex multifocal intraocular lens in "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from September 2007 to February 2008. METHODS: A prospective, longitudinal, observational and descriptive study was made in which the variables spheral equivalent, contrast sensitivity in the pre- and post

  6. Avaliação do desempenho visual da lente intraocular difrativa multifocal - Zeiss AT Lisa 809 MTM

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    Lucas Monferrari Monteiro Vianna

    2014-04-01

    Full Text Available Objetivo: Avaliar a função visual dos pacientes com implante bilateral da LIO multifocal difrativa AT-Lisa 809 MTM por meio dos exames de acuidade visual com e sem correção óptica, curva de sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF39. Métodos: Estudo clínico, prospectivo e de intervenção, que avaliou os resultados de 20 olhos de 10 pacientes, submetidos à facoemulsificação e implante de LIO, entre fevereiro e junho de 2012. Resultados: A ametropia residual média pós-operatória foi de 0,05 ± 0,42 (-0,75 a +1,25 D dioptrias esféricas e -0,30 ± 0,42 (0 a -1,25 D dioptrias cilíndricas. Na curva de desenfoque mono e binocular, a melhor acuidade visual média obtida com 0.00 D de desenfoque (AV de longe. O segundo pico foi obtido com desenfoque de -3,00 D, o que equivale à visão de perto a 33 cm. Entre esses picos, observamos uma perda de desempenho visual, com desenfoque de -2,00 D, que equivale a visão intermediária a 50 cm. A sensibilidade ao contraste foi similar aos relatados na literatura com este tipo de LIO, tanto com quanto sem ofuscamento, e é mostrada em gráficos. O questionário de função visual (VFQ-39 teve valor médio de 91,91 +- 6,82. Conclusão: A LIO multifocal difrativa AT-Lisa 809MTM (Carl Zeiss Meditec Company - Alemanha apresentou resultados condizentes com a literatura quando avaliada pelos exames de acuidade visual com e sem correção óptica, sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF 39.

  7. Correlation between Helicobacter Pylori Infection and Intra Ocular Pressure

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    Hatamizadeh

    2012-02-01

    Full Text Available Introduction: Glaucoma is one of the most common causes of blindness. It is estimated that more than 60 million people suffer from this disease of all over the world. In other hand helicobacter pylori is a gram negative bacillus that is reported in some extra-gastrointestinal system diseases recently. This study is designed to determine the association between helicobacter pylori infection and intra-ocular pressure. Methods: This was an analytical cross-sectional study that was conducted on 74 persons who were randomly selected after referring to endoscopy ward of Shohadaye Kargar hospital of Yazd in 2009. Data was analyzed by Mann-Whitney U and fisher exact tests using SPSS software (ver16. Results: Mean of intra-ocular pressure in positive helicobacter pylori group was more than negative helicobacter pylori group but there was no significant relationship (P value > 0.05, also there was no significant relationship between helicobacter pylori infection and diabetes, hypertension, hypothyroidism and hyperthyroidism (P value > 0.05. Conclusion: According to the results, more detailed studies with larger sample size are required for more reliable decisions also considering the confounder variables can help us to determine the common risk factors of these two outcomes.

  8. EFFECT OF BODY POSITIONS ON INTRA OCULAR PRESSURE

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    Rajendra

    2015-09-01

    Full Text Available BACKGROUND: Intra Ocular Pressure (IOP can be altered by changing body position. Very few studies are available in the Indian subjects. AIM: To study the effect of changes in the body position from upright posture to supine to head down tilt of - 60 0 . MATERIALS AND M ETHODS: The study group consisted of 60 subjects, 35 boys and 25 girls in the age group of 18 to 24 years, with no ocular pathology were chosen. Independent measurements of the IOP of each eye were obtained. Keelar Pulsair air impulse tonometer was used in all the subjects for IOP measurement. IOP was measured in the department of Ophthalmology, Teaching Hospital between 10AM to 12 Noon. STATISTICAL ANALYSIS : were done using Student’s paired ‘t’ test. RESULTS: The change of IOP (Increased induced by the change of position between the means of IOP’s for the sitting and supine positions was 2.789±1.03 mm Hg of all subjects, 2.825±0.226 mm Hg in males and 2.739±0.089 mm Hg in females and between the supine and in clined - 60 ⁰ position was 4.971±0.914 mm Hg of all subjects, 4.703±0.816mm Hg in males and 5.346±1.098 mm Hg in females. CONCLUSION: It is apparent that, the IOP is significantly higher in the supine than in the sitting and in the inclined than in the supin e positions. The difference was statistically significant (P<0.001.

  9. Central Corneal Thickness And Its Relationship To Intra-ocular And Epidemiological Determinants

    International Nuclear Information System (INIS)

    Tayyab, A.; Masrur, A.

    2016-01-01

    Objective: To measure central corneal thickness in Pakistani population and determine its relationship to intra-ocular pressure, age, gender and ethnicity. Study Design: Cross-sectional observation study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad, Pakistan, between December 2013 and February 2015. Methodology: The right eyes of 1000 cases (496 males and 504 females) were recruited for this study. Inclusion criteria were Pashtun or Punjabi ethnicity, intra-ocular pressure < 22 mmHg, gonioscopically open angles, cup-disk-ratio < 0.5, and age matched normal visual fields. Cases with prior ocular surgery, contact lens use, corneal pathologies, myopia or hypermetropia > ±3.0 diopters, astigmatism of > ±1.0 diopters were excluded. Central corneal thickness was measured using a TopCon non-contact specular microscope. Intra-ocular pressure was measured using Goldmann applanation tonometer. Frequency distribution, test of significance, and regression analysis was carried out using Statistical Package for Social Sciences version 20.0. Result: Mean age was 47.31 ±11.78 years. Ethnic composition was 51.6 percentage (n=516) Pashtun and 48.4 percentage (n=484) Punjabi. The mean central corneal thickness was 503.96 (±12.47) meu m, while the mean intra-ocular pressure was 15.61 (±2.68) mmHg. Regression analysis showed a significant association between central corneal thickness and intra-ocular pressure (p=0.00) and age (p=0.00). A ±100 μ change in central corneal thickness was associated with change in IOP of ±3.30 mmHg, whereas central corneal thickness decreased by 0.12 meu m per year. No significant association could be established between central corneal thickness and ethnicity (p=0.19). Conclusion: Central corneal thickness of the studied races was comparable to non-Caucasians which affects intra-ocular pressure measurements, and decreases with increasing age. No relationship was observed between central corneal thickness and

  10. Intra-Ocular Pressure Measurement in a Patient with a Thin, Thick or Abnormal Cornea.

    Science.gov (United States)

    Clement, Colin I; Parker, Douglas G A; Goldberg, Ivan

    2016-01-01

    Accurate measurement of intra-ocular pressure is a fundamental component of the ocular examination. The most common method of measuring IOP is by Goldmann applanation tonometry, the accuracy of which is influenced by the thickness and biomechanical properties of the cornea. Algorithms devised to correct for corneal thickness to estimate IOP oversimplify the effects of corneal biomechanics. The viscous and elastic properties of the cornea influence IOP measurements in unpredictable ways, a finding borne out in studies of patients with inherently abnormal and surgically altered corneal biomechanics. Dynamic contour tonometry, rebound tonometry and the ocular response analyzer provide useful alternatives to GAT in patients with abnormal corneas, such as those who have undergone laser vision correction or keratoplasty. This article reviews the various methods of intra-ocular pressure measurement available to the clinician and the ways in which their utility is influenced by variations in corneal thickness and biomechanics.

  11. Relationship between Intra Ocular Pressure and Some Risk Factors, In Northern Iran

    Directory of Open Access Journals (Sweden)

    Keihanian Faeze

    2016-04-01

    Full Text Available High intra ocular pressure (IOP often is related with open angle glaucoma. Although patients with high IOP are disposable to risk of open angle glaucoma, most of them never given it. In this study we evaluated association of hypertension and some other underlying causes with high IOP in population of patients referred to Amiralmomenin hospital during 2011-2012. This was a descriptive prospective study. Population was included patients with high IOP referred during 2012 to Amiralmomenin Hospital in Rasht. 180 patients with high IOP entered in the study. IOP of both eyes, systolic and diastolic blood pressure in admission were measured by expert assistant of ophthalmology and recorded. 55% of our patients were women. The mean age of them was 67.64±11.88 years. The mean systolic and diastolic blood pressure were respectively 128.66 ± 16.71 and 77.00 ± 9.02 mmHg. The re was a significant relation between gender, history of hypertension, alcohol abuse, hyperlipidemia and cardiac disease with high IOP in right eye (p0.05. Our study showed that systolic blood pressure can predict the high IOP. The results indicate a high impact of intraocular pressure on measures of blood pressure in an Iranian sample population.

  12. Precise modelling of the eye for proton therapy of intra-ocular tumours

    Energy Technology Data Exchange (ETDEWEB)

    Dobler, B.; Bendl, R. [Medizinische Physik, Deutsches Krebsforschungszentrum, INF 280, 69120 Heidelberg (Germany)]. E-mails: b.dobler@dkfz-heidelberg.de; barbara.dobler@gmx.de; r.bendl@dkfz-heidelberg.de

    2002-02-21

    A new method is described that allows precise modelling of organs at risk and target volume for radiation therapy of intra-ocular tumours. The aim is to optimize the dose distribution and thus to reduce normal tissue complication probability. A geometrical 3D model based on elliptic shapes was developed that can be used for multimodal model-based segmentation of 3D patient data. The tumour volume cannot be clearly identified in CT and MR data, whereas the tumour outline can be discriminated very precisely in fundus photographs. Therefore, a multimodal 2D fundus diagram was developed, which allows us to correlate and display simultaneously information extracted from the eye model, 3D data and the fundus photograph. Thus, the connection of fundus diagram and 3D data is well-defined and the 3D volume can be calculated directly from the tumour outline drawn onto the fundus photograph and the tumour height measured by ultrasound. The method allows the calculation of a precise 3D eye model of the patient, including the different structures of the eye as well as the tumour volume. The method was developed as part of the new 3D treatment planning system OCTOPUS for proton therapy of ocular tumours within a national research project together with the Hahn-Meitner-Institut Berlin. (author)

  13. Materiales. Lentes de contacto. (I)

    OpenAIRE

    Lozano Prieto, Beatriz

    2017-01-01

    La función de una lente de contacto, al igual que la de unas lentes oftálmicas en gafas, es la compensación de las ametropías ya sea miopía, hipermetropía o astigmatismo. En este trabajo se realiza un estudio metodológico basado principalmente en la evolución de las lentes de contacto y de sus materiales, desde las primeras lentes de vidrio esclerales y corneales, pasando por las lentes de material plástico, las rígidas permeables a los gases, las de hidrogel, y finalmente a las lentes de ...

  14. EFFECT OF VALSALVA MANOEUVRE ON SHORT TERM VARIATION OF INTRA OCULAR PRESSURE

    Directory of Open Access Journals (Sweden)

    Rajendra

    2015-10-01

    Full Text Available BACKGROUND: Intra ocular Pressure (IOP changes during Valsalva manoeuver (VM. AIM: To study the effect of Valsalva manoeuvre on IOP and the heart rate response. MATERIALS AND METHODS: The study group consisted of 55 volunteers, visually normal as subjects, 30 boys and 25 girls in the age group of 18 to 20 ye ars. Independent measurements of the IOP of each eye were obtained with the subject in the upright position. ECG recorded continuously before, during and after the Valsalva manoeuvre. Keelar Pulsair air impulse tonometer was used in all the subjects for IO P measurement. IOP was measured in the department of Ophthalmology, Teaching Hospital between 08AM to 10 AM. STATISTICAL ANALYSIS : were done using Paired ‘t’ test. RESULTS: The mean IOP increased by 5.53±2.138 mmHg during VM. The changes were statistically significant (<0.001. Mean IOP decreased by 2.085±0.367 mmHg during VM in a small proportion of subjects (12% which was not statistically significant. Mean recovery IOP was also lower than the resting IOP which was statistically significant (<0.001. The Valsalva ratio is calculated as the ratio of the longest RR interval (ms after the maneuver divided by the shortest RR interval (ms during the test. Mean Valsalva ratio was normal at 1.687 (range 1.2 - 2.6. CONCLUSION: IOP increased during Valsalva man oeuvre in a large number of subjects (88%. Recovery IOP was also lower than the resting IOP during the period of measurement, post VM (over a period of 5 minutes.

  15. A lente moderna

    Directory of Open Access Journals (Sweden)

    Maria Elisa Baptista

    2012-11-01

    Full Text Available Belo Horizonte, cidade moderna, abriga registros do surgimento da arquitetura moderna brasileira, flagrados na sua construção pela lente moderna do fotógrafo Wilson Baptista. Associar fragmentos das histórias arquitetônica e fotográfica nas décadas de 1930-1960 é o objetivo com este ensaio, baseado no relato pessoal da experiência de cada imagem. As referências arquitetônicas não se estendem além do necessário, por já terem sido publicadas por outros autores, limitando-se a referenciar o trabalho inventivo do fotógrafo, que traduz, em uma estética também moderna, a beleza da arquitetura belo-horizontina.

  16. Development of an accommodating intra-ocular lens - In vitro prevention of re-growth of pig and rabbit lens capsule epithelial cells

    NARCIS (Netherlands)

    van Kooten, Theo G.; Koopmans, Steven; Terwee, Thom; Norrby, Sverker; Hooymans, J. M. M.; Busscher, Henk J.

    2006-01-01

    Cataract surgery is routinely performed to replace the clouded lens by a rigid polymeric intra-ocular lens unable to accommodate. By implanting a silicone gel into an intact capsular bag the accommodating properties of the natural lens can be maintained or enhanced. The implantation success of

  17. Queratocone e lentes de contacto

    OpenAIRE

    Coutinho, I; Ramalho, M; Pedrosa, C; Pina, S; Mota, M; Santos, C; Vendrell, C

    2014-01-01

    Nos doentes com queratocone quando os óculos não possibilitam boa visão, as lentes de contacto são uma boa alternativa terapêutica. Há vários desenhos de lentes de contacto que podem ser utilizados na correção óptica do queratocone e a sua adaptação deve assegurar o menor trauma da córnea e conforto ao doente. Este trabalho pretende fazer fazendo-se breve revisão das lentes de contacto disponíveis no tratamento do queratocone.

  18. Lentes plegables suturadas a iris

    Directory of Open Access Journals (Sweden)

    Dunia Cruz Izquierdo

    Full Text Available Para la corrección quirúrgica de la afaquia existen en la actualidad varias técnicas quirúrgicas que permiten fijar los lentes intraoculares plegables o rígidos en cámara posterior suturados al iris o al sulcus ciliar. En estas circunstancias el cirujano determinará cuándo, dónde y el tipo de lente mejor a implantar. Se presenta un paciente con una afaquia traumática del ojo izquierdo, con agudeza visual sin corrección de movimiento de mano a 1 m. Se le realizó implante secundario de lente intraocular plegable de cámara posterior suturada al iris. En el examen biomicroscópico en lámpara de hendidura del ojo izquierdo se observó midriasis media paralítica, refracción dinámica de +11,00 (0,6 y tensión ocular normal. Se le realizó examen por bimicroscopía indirecta sin alteración. Al mes de operado la agudeza visual mejor corregida alcanzó la unidad de visión. Las complicaciones presentadas fueron ovalización de la pupila y depósitos de pigmentos de iris en el lente intraocular.

  19. Randvere Kool = Randvere School / Kristi Lents

    Index Scriptorium Estoniae

    Lents, Kristi, 1981-

    2013-01-01

    Kristi Lents-Esnari ja Marita Mätase (Allianss Arhitektid) kujundatud Randvere Kooli (G.H. Schüdlöffeli tee 4, Randvere küla, Viimsi) interjöörist. Hoone arhitekt Inga Raukas. Lühidalt Kristi Lents-Esnarist ja Marita Mätasest

  20. Progressive Multifocal Leukoencephalopathy

    Science.gov (United States)

    ... SEARCH Definition Treatment Prognosis Clinical Trials Organizations Publications Definition Progressive multifocal leukoencephalopathy (PML) is a disease of the white matter of the brain, caused by a virus infection ...

  1. Clinical, legal and ethical implications of the intra-ocular (off-label) use of bevacizumab (avastin)--a South African perspective.

    Science.gov (United States)

    Jansen, Rita-Marié; Gouws, Chris

    2009-06-01

    Choroidal neovascularisation is a potentially visually devastating element of various forms of eye pathology. Recent research has focused on neurovascular age-related macular degeneration (AMD) as a cause. AMD can be classified as being exudative (wet) or atrophic (dry). Wet AMD is characterised by a pathological process in which new blood vessels develop in the choroids, causing leakage of fluid and haemorrhage under the retina and leading to localised serous detachment and loss of central vision. Vascular endothelial growth factor (VEGF) stimulates growth of neovascular membranes. Treatments have until recently yielded disappointing results. Ophthalmologists are using intra-ocular injections of bevacizumab (Avastin), an anti-VEGF, to treat AMD. Avastin appears to be safe and effective in the short term, but its intra-ocular administration is entirely off-label. Avastin is registered for treating metastatic colorectal and breast cancer. The off-label use of medication is an important part of mainstream, legitimate medical practice worldwide. Lawyers representing plaintiffs injured by drugs increasingly encounter off-label use claims. From a legal/ethical point of view the off-label use of medication represents a delicate balance between the statutory regulation of medication and a physician's prerogative to prescribe medication that in his or her medical opinion will be beneficial to the patient. The main reason for the controversy created by the off-label use of Avastin is that there are anti-VEGF drugs on the market that have formal approval for the treatment of AMD (and other eye conditions). Lucentis, for example, is extremely expensive, with treatment cost approximately 50 times that of Avastin. Many patients suffering from AMD and macular oedema cannot afford the registered product. The off-label use of Avastin has passed the innovative or experimental stages, as ophthalmologists have used it regularly and openly for a long time, with good success. Such use

  2. Multifocal Congenital Hemangiopericytoma.

    Science.gov (United States)

    Robl, Renata; Carvalho, Vânia Oliveira; Abagge, Kerstin Taniguchi; Uber, Marjorie; Lichtvan, Leniza Costa Lima; Werner, Betina; Mehrdad Nadji, Mehrdad

    2017-01-01

    Congenital hemangiopericytoma (HPC) is a rare mesenchymal tumor with less aggressive behavior and a more favorable prognosis than similar tumors in adults. Multifocal presentation is even less common than isolated HPC and hence its clinical and histologic recognition may be challenging. A newborn infant with multifocal congenital HPC causing severe deformity but with a favorable outcome after chemotherapy and surgical removal is reported. © 2016 Wiley Periodicals, Inc.

  3. INTRAOCULAR TRANSMISSIBLE VENEREAL TUMOR IN A DOG TUMOR VENÉREO TRANSMISSÍVEL INTRA-OCULAR EM CÃO

    Directory of Open Access Journals (Sweden)

    Geórgia Nadalini Rodrigues

    2001-02-01

    Full Text Available Canine transmissible venereal tumor (TVT is a round cell neoplasm occurring on the external genital mucosa of male and female dogs. Transmission is by cell implantation during coitus, licking, or other interaction between an affected dog and a susceptible host. Metastasis of the tumor rarely occurs. This report describes an unusual presentation of TVT with intraocular involvement and inguinal lymph nodes metastasis. The subject was a six-year-old, intact, male, Brazilian Terrier dog with a history of abnormal masses in the right eye, penis and several subcutaneous nodules in the inguinal area. Histopathological examination of the eye specimens as well as cytologic examination of penile mass and subcutaneous nodules revealed similar findings. The examination revealed round cells containing a large nuclei with prominent, central located nucleoli and a pale cytoplasm containing few small, clear round vacuoles. Histologically, the subcutaneous nodules in the inguinal area were lymph nodes. The diagnosis of TVT with intraocular involvement and lymph nodes metastasis was based on clinical, cytologic and histopathologic findings.Tumor venéreo transmissível (TVT é uma neoplasia de células redondas que acomete a mucosa genital externa de cães, machos e fêmeas. A transmissão decorre da implantação de células tumorais durante o coito, brigas ou interações entre animais portadores e susceptíveis. Existem relatos referindo-se a localizações atípicas do TVT, mas metástases raramente ocorrem. O presente relato descreve um caso incomum de TVT, com acometimento intra-ocular e metástases nos linfonodos ingüinais, num cão Terrier Brasileiro, com seis anos de idade. O animal apresentava massas anormais de tecido no olho direito, extremidade do pênis e aumento de volume de linfonodos da região ingüinal. A histopatologia do globo ocular e as citologias da massa peniana e dos nódulos subcutâneos evidenciaram aspectos citológicos semelhantes

  4. Pesquisa de anticorpos anti Toxoplasma gondii em fluidos intra-oculares (humor vítreo e humor aquoso) de pacientes com toxoplasmose ocular, na cidade de Belém, PA

    OpenAIRE

    Carmo,Ediclei Lima do; Almeida,Edmundo Frota; Bichara,Cléa Nazaré; Póvoa,Marinete Marins

    2005-01-01

    Foi realizada pesquisa de anticorpos IgG, IgM e IgA anti-Toxoplasma gondii no soro e fluidos intra-oculares (humor aquoso e vítreo) de pacientes com toxoplasmose ocular. A partir dos resultados obtidos verificou-se que anticorpos IgG e IgA intraocular anti-Toxoplasma gondii podem vir a ser importantes marcadores no diagnóstico de toxoplasmose ocular.

  5. Lentes de contacto en el deporte

    Directory of Open Access Journals (Sweden)

    Lluïsa Quevedo i Junyent

    2007-06-01

    Full Text Available Tras una completa evaluación optométrica, la primera responsabilidad del especialista, es procurar al deportista amétrope (miope, hipermétrope, astígmata... una óptima calidad de visión, ya sea con gafas o, preferiblemente, con lentes de contacto, por las numerosas ventajas que éstas presentan para el deportista. En los últimos años, especialmente, la industria de las lentes de contacto viene experimentando una evolución imparable, con grandes innovaciones a nivel de materiales, diseños y frecuencias de reemplazo que se traducen en mayor calidad de visión, confort y seguridad para el usuario. Las lentes de contacto desechables (usar y tirar, suelen ser de primera elección para los deportistas. En esta línea se encuentra la lente de contacto Nike Max Sight, de reciente comercialización en nuestro país, y que sin duda, como ya está sucediendo en los EUA, puede comportar una pequeña revolución en el contexto deportivo

  6. Nuevas aplicaciones de las lentes de contacto

    OpenAIRE

    Blanco Menéndez, Patricia

    2017-01-01

    Revisión bibliográfica de los estudios para el seguimiento y monitorización de patologías de elevada prevalencia (glaucoma y diabetes mellitus) de una forma no invasiva y administración de fármacos mediante el uso de lentes de contacto. Grado en Optica y Optometría

  7. 7 CFR 1710.107 - Amount lent for acquisitions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Amount lent for acquisitions. 1710.107 Section 1710... GUARANTEES Loan Purposes and Basic Policies § 1710.107 Amount lent for acquisitions. The maximum amount that will be lent for an acquisition is limited to the value of the property, as determined by RUS. If the...

  8. Testing the biocompatibility of a glutathione-containing intra-ocular irrigation solution by using an isolated perfused bovine retina organ culture model - an alternative to animal testing.

    Science.gov (United States)

    Januschowski, Kai; Zhour, Ahmad; Lee, Albert; Maddani, Ramin; Mueller, Sebastien; Spitzer, Martin S; Schnichels, Sven; Schultheiss, Maximilian; Doycheva, Deshka; Bartz-Schmidt, Karl-Ulrich; Szurman, Peter

    2012-03-01

    The effects of a glutathione-containing intra-ocular irrigation solution, BSS Plus©, on retinal function and on the survival of ganglion cells in whole-mount retinal explants were studied. Evidence is provided that the perfused ex vivo bovine retina can serve as an alternative to in vivo animal testing. Isolated bovine retinas were prepared and perfused with an oxygen-saturated standard irrigation solution, and an electroretinogram was recorded to assess retinal function. After stable b-waves were detected, the isolated retinas were perfused with BSS Plus for 45 minutes. To investigate the effects of BSS Plus on photoreceptor function, 1mM aspartate was added to the irrigation solution in order to obtain a-waves, and the ERG trace was monitored for 75 minutes. For histological analysis, isolated whole retinal mounts were stored for 24 hours at 4°C, in the dark. The percentages of cell death in the retinal ganglion cell layer and in the outer and inner nuclear layers were estimated by using an ethidium homodimer-1 stain and the TUNEL assay. General swelling of the retina was examined with high-resolution optical coherence tomography. During perfusion with BSS Plus, no significant changes in a-wave and b-wave amplitudes were recorded. Retinas stored for 24 hours in BSS Plus showed a statistically significant smaller percentage (52.6%, standard deviation [SD] = 16.1%) of cell death in the retinal ganglion cell layer compared to the control group (69.6%, SD = 3.9, p = 0.0031). BSS Plus did not seem to affect short-term retinal function, and had a beneficial effect on the survival of retinal ganglion cells. This method for analysing the isolated perfused retina represents a valuable alternative for testing substances for their retinal biocompatibility and toxicity. 2012 FRAME.

  9. Numerical analysis of specific absorption rate in the human head due to a 13.56 MHz RFID-based intra-ocular pressure measurement system

    International Nuclear Information System (INIS)

    Hirtl, Rene; Schmid, Gernot

    2013-01-01

    A modern wireless intra-ocular pressure monitoring system, based on 13.56 MHz inductively coupled data transmission, was dosimetrically analyzed with respect to the specific absorption rate (SAR) induced inside the head and the eye due to the electromagnetic field exposure caused by the reader antenna of the transmission system. The analysis was based on numerical finite difference time domain computations using a high resolution anatomical eye model integrated in a modern commercially available anatomical model of a male head. Three different reader antenna configurations, a 7-turn elliptic (30 mm × 50 mm) antenna at 12 mm distance from the eye, a flexible circular antenna (60 mm diameter, 8 turns on 2 mm substrate) directly attached to the skin, and a circular 7-turn antenna (30 mm diameter at 12 mm distance to the eye) were analyzed, respectively. Possible influences of the eye-lid status (closed or opened) and the transponder antenna contained in a contact lens directly attached to the eye were taken into account. The results clearly demonstrated that for typical reader antenna currents required for proper data transmission, the SAR values remain far below the limits for localized exposure of the head, as defined by the International Commission for Non-Ionizing Radiation Protection. Particularly the induced SAR inside the eye was found to be substantially (orders of magnitudes for typical reader antenna currents in the order of 1 A turn) below values which have been reported to be critical with respect to thermally induced adverse health effects in eye tissues. (note)

  10. Multifocal Epithelial Hyperplasia.

    Science.gov (United States)

    Agnew, Caitlin; Alexander, Sherene; Prabhu, Neeta

    2017-01-15

    Multifocal epithelial hyperplasia is a rare disease associated with human papilloma virus types 13 and 32. Diagnosis is based on clinical and histopathological findings, and most lesions are asymptomatic and regress spontaneously with time. The purpose of this paper is to describe a five-year-old girl who presented with multiple intraoral lesions on the buccal mucosa and tongue, which regressed spontaneously in 15 months.

  11. Prótese intra-ocular de resina acrílica em cães e gatos Acrylic resin intraocular prosthesis in dogs and cats

    Directory of Open Access Journals (Sweden)

    S.C. Rahal

    2000-08-01

    Full Text Available Foram atendidos no Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Unesp - Campus de Botucatu, 11 animais (oito cães e três gatos, com alterações oftálmicas unilaterais graves que levaram à perda total da função ocular (protrusão de globo com injúria nervosa e estrutural, perfurações de córnea com perda de conteúdo intra-ocular e endoftalmites, entre outras. Os animais, com idades entre dois meses e 10 anos, foram submetidos à evisceração e posterior inclusão de esfera de resina acrílica (metilmetacrilato na capa córneo-escleral ou escleral. As esferas foram previamente confeccionadas e esterilizadas por autoclavagem. No pós-operatório foram utilizados antiinflamatórios e antibioticoterapia tópica combinada ou não a sistêmica. O período de observação variou de 2 meses a 3 anos e os aspectos avaliados foram secreção ocular, blefarospasmo, sinais de desconforto e estética. Obtiveram-se resultados satisfatórios em oito casos. Concluiu-se que a resina acrílica pode ser uma alternativa para uso como inclusão em cavidade anoftálmica.Eleven animals (eight dogs and three cats, aged between two months and ten years were referred to the Veterinary Hospital of Faculty of Veterinary Medicine and Animal Science - Unesp, Botucatu, Brazil. These animals presented severe unilateral ophthalmic changes that lead to a total loss of ocular function, such as prolapsed eyes with nervous and structural injury, corneal damage with loss of intraocular contents or endophthalmitis among others. They were submitted to evisceration followed by the insertion of an acrylic resin prosthesis (methylmethacrylate in the corneoscleral or scleral shell. The spheres were previously made and sterilized by autoclave. The postoperative medical therapy included topical and systemic broad-spectrum antibiotics for seven days and anti-inflammatory drugs. The follow-up time varied from two months to three years. The evaluated

  12. Lentes progressivas x lentes multifocais: um estudo baseado na geometria analítica do cone

    Directory of Open Access Journals (Sweden)

    Araújo Marília Cavalcante

    2004-01-01

    Full Text Available OBJETIVO: Compreender, por meio de figuras e funções matemáticas do cone, as lentes progressivas e mostrar que elas não são lentes multifocais porque, nelas, a refração da luz não obedece as leis da geometria euclidiana. MÉTODOS: Foi feito um estudo da geometria analítica do cone, com o programa de computador Auto-CAD 14, dando enfoque óptico às figuras geométricas obtidas com a sua secção. RESULTADOS: Pela análise das figuras obtidas da secção do cone, pudemos observar as superfícies que compõem as lentes progressivas. Estas superfícies são compostas de elipse, círculo, parábola e hipérbole. Diferente do que é dito na literatura, encontramos as elipses com diâmetro maior nas ordenadas e de mesmo sentido seguida por duas superfícies inferiores que são parábola e hipérbole e não o contrário. CONCLUSÕES: As lentes progressivas diferentemente das lentes multifocais apresentam prismas nos centros ópticos como decorrência da sua estrutura. No final, fizemos análise das suas formas mostrando o limite teórico da sua evolução.

  13. Desempenho visual dos pacientes pseudofácicos com diferentes lentes intraoculares

    Directory of Open Access Journals (Sweden)

    Wilson Takashi Hida

    2013-10-01

    Full Text Available OBJETIVO: Comparar a performance visual dos pacientes submetidos ao implante das lentes intraoculares multifocais difrativas Tecnis® MF ZM900, Acrysof® Restor® SN60D3, Acrysof® SN60WF e Acrysof® SN60AT. MÉTODOS: Estudo prospectivo comparativo, não randomizado, que incluiu 142 olhos de 71 pacientes com catarata, provenientes do ambulatório de oftalmologia do HC-FMUSP. A avaliação oftalmológica contou com medida da acuidade visual para longa, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste, pupilometria e análise de frente de onda por meio do aberrômetro. Todos os exames foram realizados com seis meses de pós-operatório. RESULTADOS: A média de idade dos pacientes foi de 60,7±6,6 anos no grupo Tecnis, 63,1±4,4 anos no grupo Restor e 63,7±4,2 anos no grupo monofocal (SN60AT no olho contralateral SN60WF. A acuidade visual para perto não corrigida e corrigida para longe foi estatisticamente superior nos grupos multifocal Restor e multifocal Tecnis em comparação ao grupo monofocal SN60AT/SN60WF (p<0,001. Não houve diferença estatística entre os grupos na comparação da acuidade visual para longe (p=0,56. A sensibilidade ao contraste fotópica monocular foi estatisticamente inferior nos grupos Restor e Tecnis (p<0,001. A SN60AT apresentou maior aberração esférica comparada a todas as outras lentes (p<0,001. A Tecnis se mostrou com menores valores médios de aberrações esféricas na comparação com a Restor (p<0.001. CONCLUSÃO: A Restor e Tecnis apresentaram melhor acuidade visual para perto do que o grupo monofocal SN60AT/SN60WF. Todas as lentes intraoculares promoveram boa visão para longe. O grupo da Tecnis apresentou melhor sensibilidade de contraste, menos aberrações ópticas e melhor visão intermediária que o grupo Restor.

  14. Lentes de contacto em idade pediátrica

    OpenAIRE

    Mota, M; Vendrell, C; Ramalho, M; Santos, C; Pedrosa, C; Coutinho, I; Lopes, AS; Silva, D

    2015-01-01

    Revisão sobre os tipos de lentes de contacto para utilização na idade pediátrica. Regras de adaptação, indicações e contraindicações ao uso de lentes de contacto na criança. Descrição das melhores opções na afaquia.

  15. Estudo descritivo da resposta de acuidade visual sem correção e pressão intra-ocular computadorizada de não contato em jogadores de futebol amadores e profissionais

    Directory of Open Access Journals (Sweden)

    Emídio Valenti Tavares

    1999-08-01

    Full Text Available O principal objetivo deste estudo foi verificar as possíveis alterações de acuidade visual e pressão intra-ocular em jogadores de futebol. A clínica Oftalmos e Cirurgia Oftalmológica submeteu à avaliação oftalmológica 127 atletas futebolistas provenientes de várias categorias, incluindo mulheres, com idades variando de 14 a 33 anos. Todos foram submetidos a testes de acuidade visual sem correção, utilizando-se a tabela de Snellen e avaliando-se a pressão intra-ocular de não contato com um tonômetro computadorizado (modelo TX-10, Canon, EUA. Além disso, os atletas foram submetidos a exame de auto-refração, no equipamento auto-refrator (modelo R-30, Canon, EUA. Os seguintes parâmetros utilizados e os resultados encontrados foram: dos 127 atletas avaliados, 56 (44% apresentaram alterações de auto-refração, consideradas de grau mais ou menos importante em um ou ambos os olhos. No teste de acuidade visual, 3% e 2,4% dos atletas apresentaram, no OD e OE, somente 20/100 e 20/200 pés de visão, respectivamente. Em uma jogadora, foi constatada catarata puntata congênita. Os resultados da tonometria mostraram, em 5 atletas de cor negra, quadro suspeito de glaucoma (necessitando investigação mais apurada.Concluindo, o estudo comprovou a importância da oftalmologia como medida preventiva e/ou corretiva na identificação de possíveis alterações oftalmológicas em atletas futebolistas, devendo ser uma prática rotineira nesse esporte.

  16. Pärt, Arvo: "Miserere", "Festina lente" / Volkmar Fischer

    Index Scriptorium Estoniae

    Fischer, Volkmar

    1991-01-01

    Uuest heliplaadist Pärt, Arvo: "Miserere", "Festina lente", "Sarah Was Ninety Years Old". The Hilliard Ensemble. Orchester der Beethovenhalle Bonn. Dirigent Dennis Russel Davies (ECM Records, distr Amigo)

  17. Bacilos gram negativos, contaminantes más prevalentes en lentes de contacto blandos usados

    OpenAIRE

    Castiblanco, Diana; Rodríguez, Martha Fabiola; Mayorga C., Myriam Teresa

    2007-01-01

    Las bacterias son los contaminantes más frecuentes de los lentes de contacto. Objetivo: identificar el tipo de depósitos microbiológicos en lentes de contacto blando (LCB) usados. Materiales y Métodos: 100 lentes de contacto blandos de usuarios o de prueba  de las ópticas, recolectándose 25 lentes para cada grupo de la FDA (Grupo1, 2, 3 y 4, según el contenido de agua e ionicidad del polímero). Los lentes se almacenaron por 20 días en sus estuches individuales hasta su estudio. A cada lente, ...

  18. Compression medullaire lente secondaire a un lymphome de Burkitt ...

    African Journals Online (AJOL)

    faciale à la fin du 1er mois et une récupération neurologique au bout d'un an. La localisation secondaire intra rachidienne d'un LB bien que rare doit être présente à l'esprit surtout en face d'une compression médullaire lente survenue dans un ...

  19. Primary multifocal osseous lymphoma in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Takashi S.P. [University of Iowa, Carver College of Medicine, Iowa City, IA (United States); Ferguson, Polly J. [University of Iowa, Department of Pediatrics, Iowa City, IA (United States); Khanna, Geetika [Washington University, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

    2008-12-15

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  20. Efeito de drogas utilizadas no tratamento de hipertensão arterial sistêmica sobre a pressão intra-ocular: estudo experimental no cão

    Directory of Open Access Journals (Sweden)

    Hashimoto Mitsuo

    2002-01-01

    Full Text Available Objetivo: Estudar os efeitos de duas drogas utilizadas no tratamento de hipertensão arterial sistêmica (captopril e propranolol sobre a pressão intra-ocular (PIO e pressão de perfusão (PP em cães anestesiados. Métodos: Foram estudados 24 cães, divididos em 3 grupos de 8. No primeiro grupo (GI, foi administrado captopril (um inibidor da enzima conversora de angiotensina na dose de 1,5 mg/kg por via endovenosa. No segundo grupo (GII, foi administrado propranolol (um beta-bloqueador na dose de 1,5 mg/kg por via endovenosa. O terceiro grupo (GIII foi o grupo controle. A PIO e a pressão arterial média (PAm foram medidas por manometria. A pressão de perfusão (PP foi calculada pela diferença entre a PAm e a PIO. A freqüência cardíaca (FC foi monitorada com oxímetro de pulso. Os parâmetros foram estudados em 6 momentos (0, 10, 30, 60, 90 e 120 minutos. Resultados: Houve redução estatisticamente significativa da PIO (p<0,05 nos grupos em que foram administrados captopril e propranolol, sem diferença entre as drogas. Com captopril, houve redução da PAm e da PP aos 10 e 30 minutos. Com propranolol, não houve redução da PAm ou da PP. Conclusão: Houve redução da PIO com uso do captopril e também do propranolol. Entretanto, a redução acentuada da PAm e da PP causadas pelo captopril, podem ser indesejáveis para a irrigação do nervo óptico.

  1. Procedimiento para elaborar una lente intraocular monofocal asférica isoplanática y lente obtenida empleando dicho procedimiento

    OpenAIRE

    Barbero, Sergio; Marcos, Susana; Dorronsoro, Carlos; Montejo, Javier; Salazar Salegui, Pedro

    2010-01-01

    Procedimiento para elaborar una lente intraocular monofocal asférica isoplanática y lente obtenida empleando dicho procedimiento. Permite obtener lentes oftálmicas monofocales asféricas isoplanáticas en un rango visual de hasta 25º (preferentemente hasta 10º) de amplitud. El procedimiento comprende las etapas de: 1.- Definición matemática de un modelo de ojo afáquico; 2.- Definición matemática de un modelo de lente intraocular; 3.- Definición matemática de la implantac...

  2. Efeito do filtro de ultravioleta em lentes de contato hidrofílicas de alta hidratação Ultraviolet filter effect on hydrophilic high hydrated contact lenses

    Directory of Open Access Journals (Sweden)

    Arlindo José Freire Portes

    2008-06-01

    Full Text Available A exposição à radiação ultravioleta está relacionada ao aparecimento de patologias oculares como ceratites, cataratas, degenerações maculares ou pterígio. Esta radiação está dividida em 3 tipos de acordo com o seu comprimento de onda: Uv-A (320-400nm, Uv-B (290-320nm e Uv-C (100-290nm. A indústria óptica desenvolveu filtros de ultravioleta para lentes intra-oculares, lentes de contato e lentes de óculos. OBJETIVO: Avaliar a eficácia do filtro de ultravioleta em lentes de contato de alta hidratação. MÉTODOS: Seis grupos de lentes de contato de alta hidratação e de marcas diferentes, contendo 3 unidades novas e iguais foram estudadas, observando-se o percentual de transmissão da energia luminosa de 200 a 400 nm através de um espectofotômetro. RESULTADOS: Os 3 grupos que apresentavam filtro de ultravioleta causaram uma queda abrupta na transmissão da radiação ultravioleta de 400 nm até 340 nm, ocorrendo um aumento na transmissão entre 240 a 300 nm até um nível máximo de 45%. Abaixo de 240 nm e entre 300 e 340 nm, houve um completo bloqueio da transmissão da radiação ultravioleta. Os 3 grupos que não apresentavam filtros de ultravioleta causaram uma queda abrupta na transmissão da radiação ultravioleta abaixo de 240 nm, ocorrendo um bloqueio completo de transmissão abaixo de 220 nm. CONCLUSÃO: As lentes de contato sem filtro Uv testadas não bloquearam com eficácia a radiação Uv-A, B ou C, e as com filtro bloquearam quase totalmente a radiação Uv-B e parcialmente a radiação Uv-A e Uv-C.The exposure to ultraviolet radiation is associated with the beginning of ocular pathologies like keratites, cataract, age-related macular degeneration and pterygium. This radiation is divided in 3 bands according to the wave length: Uv-A (320-400, Uv-B (290-320, Uv-C (100-290. The optic industry developed ultraviolet filters to intraocular lenses, contact lenses and spectacle lenses. PURPOSE: The issue of this work is

  3. Úlceras corneales en usuarios de lentes de contacto

    Directory of Open Access Journals (Sweden)

    Darlen Rodríguez Rivero

    Full Text Available El empleo de lentes de contacto se ha incrementado a nivel mundial. En la actualidad su uso no se restringe solamente a la corrección óptica, sino que se utilizan con fines terapéuticos, ya que generan comodidad y estética en múltiples afecciones oculares. Es de esperar el creciente aumento de las complicaciones relacionadas con el uso de estos, por ser la queratitis bacteriana potencialmente grave y devastadora para el globo ocular. Se realizó una revisión bibliográfica acerca de las úlceras corneales en portadores de lentes de contacto con el objetivo de describir su epidemiología y las formas de prevenir esta complicación.

  4. Observaci\\'on de lentes gravitatorias con ALMA

    OpenAIRE

    Bonilla, A.; Toloza, O.; Fuentes, I.; Motta, V.

    2016-01-01

    Gravitational lensing is a fundamental tool for cosmology. A recent instrument which will provide more information for models of these objects is ALMA. Our goal is to select lens candidates to observe with ALMA and then model them using GravLens Software. We had selected 12 quadruple images systems from the CASTLES database, which show a high probability of observing extended sources in the submillimetric range. These new data will allow us to improve existing models. Las lentes gravitatorias...

  5. Lentes esclerales: características e indicaciones

    Directory of Open Access Journals (Sweden)

    Oreste Mariño Hidalgo

    Full Text Available Los lentes de contacto esclerales o de apoyo escleral constituyen una de las opciones terapéuticas más relevantes en el tratamiento y corrección óptica de las enfermedades corneales primaria o secundarias, que traen como consecuencia alteraciones de la curvatura, de la regularidad de la superficie y de su transparencia. La evolución y el desarrollo de este tipo de lentes han abierto un diapasón de múltiples opciones para su uso. En la actualidad se prescriben por numerosos especialistas y ópticas del mundo con una gran aceptación y confort de los pacientes que los utilizan, lo que ha popularizado su comercialización. Realizamos una búsqueda de diversos artículos publicados en los últimos diez años para profundizar en el conocimiento de las características e indicaciones de los lentes de contacto esclerales.

  6. Mechanical properties of intra-ocular lenses

    Science.gov (United States)

    Ehrmann, Klaus; Kim, Eon; Parel, Jean-Marie

    2008-02-01

    Cataract surgery usually involves the replacement of the natural crystalline lens with a rigid or foldable intraocular lens to restore clear vision for the patient. While great efforts have been placed on optimising the shape and optical characteristics of IOLs, little is know about the mechanical properties of these devices and how they interact with the capsular bag once implanted. Mechanical properties measurements were performed on 8 of the most commonly implanted IOLs using a custom build micro tensometer. Measurement data will be presented for the stiffness of the haptic elements, the buckling resistance of foldable IOLs, the dynamic behaviour of the different lens materials and the axial compressibility. The biggest difference between the lens types was found between one-piece and 3-piece lenses with respect to the flexibility of the haptic elements

  7. Intra-ocular pressure-lowering effects of a Rho kinase inhibitor, ripasudil (K-115), over 24 hours in primary open-angle glaucoma and ocular hypertension: a randomized, open-label, crossover study.

    Science.gov (United States)

    Tanihara, Hidenobu; Inoue, Toshihiro; Yamamoto, Tetsuya; Kuwayama, Yasuaki; Abe, Haruki; Suganami, Hideki; Araie, Makoto

    2015-06-01

    To investigate the intra-ocular pressure (IOP)-lowering effects of a selective Rho kinase inhibitor, ripasudil (K-115), over 24 hr in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). In this multicenter, prospective, randomized, open-label, 3-period, Latin-square crossover clinical study, 28 patients with POAG or OHT whose IOP level was 21 mmHg or higher were subdivided into three groups. Each patient was treated with placebo and ripasudil in concentrations of 0.2 and 0.4%, at 9:00 and 21:00 on day 1 through a total of 3 periods separated by washout periods. IOP was measured at 9:00, 10:00, 11:00, 13:00, 16:00, 19:00, 21:00, 22:00 and 23:00 on day 1, and 1:00, 4:00, 7:00 and 9:00 on day 2 in sitting position using Goldmann applanation tonometer. Main outcome measure was the IOP reduction of placebo and ripasudil from baseline. The mean IOP reduction was -5.2 mmHg for 0.2%, -6.4 mmHg for 0.4% and -2.0 mmHg for placebo at 2 hr after the first instillation. Also, the corresponding values were -6.8 mmHg for 0.2%, -7.3 mmHg for 0.4% and -4.1 mmHg for placebo at 2 hr after the second instillation. Statistically significant IOP reduction, compared with placebo, was found for both 0.2 and 0.4% from 1 through 7 hr after each instillation. In safety, conjunctival hyperaemia was observed in 22 patients (79%) for 0.2%, 27 patients (96%) for 0.4% and three patients (11%) for placebo. Ripasudil is a promising new topical medication to lower IOP for at least 7 hr after instillations in patients with POAG or OHT. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. Multifocal osteogenic sarcoma in Paget's disease

    International Nuclear Information System (INIS)

    Vuillemin-Bodaghi, V.; Parlier-Cuau, C.; Laredo, J.D.; Cywiner-Golenzer, C.; Quillard, A.; Kaplan, G.

    2000-01-01

    The most serious complication of Paget's disease is sarcomatous degeneration of pagetic bone. Multifocal sarcomatous degeneration occurs mainly in polyostotic Paget's disease. Multifocal Paget's sarcoma is uncommon and can arise in any site. We report two cases of synchronous multifocal sarcomatous degeneration. The two patients were elderly women (aged 77 and 86 years, respectively) who developed sarcomatous lesions concomitantly, in the first case report in left ilium, left tibia, and first lumbar vertebra and in the second case report in the skull, right ilium, and sacrum. Whether these cases are due to the simultaneous development of several primaries or to metastases from a single primary remains unclear. (orig.)

  9. Chronic recurrent multifocal osteomyelitis (CRMO)

    International Nuclear Information System (INIS)

    Schilling, F.

    1998-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an unusual clinical entity. More than 200 cases are described in the literature and it is presented here with special reference to its radiological aspects. It is an acquired disease of the skeleton which occurs predominantly during childhood and adolescence. About ten per cent of cases begin in early or, rarely, in later adult life. This variant is described here for the first time and is discussed as 'adult CRMO'. The underlying pathology is a bland, predominantly lympho-plasma cellular osteomyelitis which is self-limiting and leads to bone sclerosis (Garre). It probably involves an abnormal immune process which follows an infection but remains clinically latent and remains aseptic and sterile. In a quarter of cases there is an association with pustulosis palmo-plantaris and its relationship with psoriatic arthropathy is discussed. The clinical, histopathological and imaging features (radiological and particularly MRT) and the bone changes are described. (orig./AJ) [de

  10. Progressive multifocal leukoencephalopathy: new concepts

    Directory of Open Access Journals (Sweden)

    Marco A. Lima

    2013-09-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory síndrome, new treatment strategies and other JCV related CNS diseases.

  11. O cálculo do poder das lentes intra-oculares e o Orbscan-II. Parte 1: O poder óptico da córnea normal Power calculation of intraocular lenses and the Orbscan-II. Part 1: The power of the normal cornea

    Directory of Open Access Journals (Sweden)

    Érika C. Canarim de Oliveira

    2003-10-01

    Full Text Available OBJETIVO: Avaliar o poder dióptrico da porção central da córnea normal. MÉTODOS: Análise retrospectiva da topografia por varredura de fenda de luz e disco de Plácido em 30 olhos normais. RESULTADOS: Os poderes médios ceratométrico, anterior, da espessura e total; ópticos ceratométrico e total; axiais ceratométrico e total; tangencial total, equivalente e a soma do poder médio de ambas superfícies foram semelhantes (p>0,8361 nas quatro áreas centrais analisadas (0,04, 1, 3 e 5 mm de diâmetro. O poder médio posterior diminuiu de -6,62 D até -6,35 D (p=0,0030. A espessura média aumentou de 524 µm até 554 µm (p=0,0231, representando 0,13 D do poder total da córnea. Os poderes óptico (p0,4907 e à soma do poder de ambas superfícies (p>0,3868. O poder médio anterior foi ao redor de 7,5 vezes maior que o poder médio posterior. CONCLUSÕES: O poder real da córnea calculado usando ambas superfícies, sua espessura e os índices de refração fisiológicos é menor que o poder convencionalmente aceito e determinado pela medição da curvatura da superfície anterior e o índice de refração ceratométrico da córnea (FPURPOSE: To evaluate the dioptric power of the normal central cornea. METHODS: Retrospective analysis of combined slit-scanning and Placido-ring topography in 30 normal eyes. RESULTS: Keratometric-mean, anterior-mean, thickness-mean, and total-mean powers; keratometric-optical and total-optical, keratometric-axial and total-axial, and total-tangential powers; equivalent power and the addition of anterior and posterior mean powers, were similar (p>0.8361 in the four analyzed central areas with 0.04, 1.0, 3.0, and 5.0 mm diameter. The posterior-mean power decreased (p=0.0030 from -6.62 D to -6.35 D. The average thickness increased (p=0.0231 from 524 µm to 554 µm, representing 0.13 D of total-mean corneal power. Keratometric-optical (p0.4907, and to the addition of anterior-mean and posterior-mean powers (p>0.3868. Anterior-mean power was about 7.5 greater than posterior-mean power. CONCLUSIONS: The real power of the cornea calculated using both surfaces, its thickness, and the physiologic refraction indices is smaller (less positive than the power usually accepted and determined by the anterior corneal surface radius and the keratometric index of refraction (F

  12. Progressive multifocal leukoencephalopathy in transplant recipients

    NARCIS (Netherlands)

    Mateen, Farrah J.; Muralidharan, RajaNandini; Carone, Marco; van de Beek, Diederik; Harrison, Daniel M.; Aksamit, Allen J.; Gould, Mary S.; Clifford, David B.; Nath, Avindra

    2011-01-01

    Transplant recipients are at risk of developing progressive multifocal leukoencephalopathy (PML), a rare demyelinating disorder caused by oligodendrocyte destruction by JC virus. Reports of PML following transplantation were found using PubMed Entrez (1958-July 2010). A multicenter, retrospective

  13. Multifocal, chronic osteomyelitis of unknown etiology

    International Nuclear Information System (INIS)

    Kozlowski, K.; Beluffi, G.; Feltham, C.; James, M.; Nespoli, L.; Tamaela, L.; Pavia Univ.; Municipal Hospital, Nelson; Medical School, Jakarta

    1985-01-01

    Four cases of multifocal osteomyelitis of unknown origin in childhood are reported. The variable clinical and radiographic appearances of the disease are illustrated and the diagnostic difficulties in the early stages of the disease are stressed. (orig.) [de

  14. [Therapeutic qualities of a lente preparation of swine insulins manufactured by Pharmachem].

    Science.gov (United States)

    Andreev, D; Bozadzhieva, E; Pampulov, L; Penchev, I; Uzunova, B

    1977-01-01

    The therapeutic effect of swine insulin preparation Lente, "Pharmachim" production was studied in 50 diabetics. Its hypoglycemizing activitis compared with that of standardized insulin Lente--"Novo", extract of bovine pancreas. The Bulgarian preparation was found to be very similar to the preparation Lente-Novo in its pharma-codynamic properties and could successfully be used in the diabetes melitus treatment. Insulin Lente Pharmachim is presumed to have lower antigenicity as an extract of swine pancreas, which is actually its great advantage for the therapeutic practice.

  15. Monilapsisten perheiden lentäen tapahtuvat valmismatkat ulkomaille

    OpenAIRE

    Argillander, Rita

    2015-01-01

    Tässä opinnäytetyössä pyrittiin selvittämään ulkomaille lentäen matkuste-levien monilapsisten perheiden valmismatkan sisältöä sekä osto- ja valin-taprosessiin vaikuttavia tekijöitä. Työssä kartoitettiin mitä monilapsiset perheet arvostavat ja tarvitsevat viihtyäkseen valmismatkalla. Työn tarkoi-tus oli auttaa matkantarjoaja Apollomatkoja kehittämään vanhoja ja tuot-tamaan uusia palveluja monilapsisten perheiden toiveiden mukaan. Työssä käsiteltiin lisäksi mitä tekijöitä lapsiperheiden itse tu...

  16. Drug-induced progressive multifocal leukoencephalopathy

    DEFF Research Database (Denmark)

    Vermeer, N S; Straus, S M J M; Mantel-Teeuwisse, A K

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points in their life......Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points...

  17. Multifocal necrotizing fasciitis following Hirshsprung's disease ...

    African Journals Online (AJOL)

    Multifocal necrotizing fasciitis following Hirshsprung's disease surgery away from the surgical wound site. Ahmed A. Haseeb, Shadi Okasha and Atef Elbarawi. Necrotizing fasciitis (NF) is a life-threatening infection with rapidly progressive necrosis. Escherichia coli is rarely reported as causative agent of type 2 NF.

  18. Multifocal chronic osteomyelitis of unknown etiology

    International Nuclear Information System (INIS)

    Kozlowski, K.; Masel, J.; Harbison, S.; Yu, J.; Royal Brisbane Children Hospital; Regional Hospital Bowral

    1983-01-01

    Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. (orig.)

  19. [Incremental cost effectiveness of multifocal cataract surgery].

    Science.gov (United States)

    Pagel, N; Dick, H B; Krummenauer, F

    2007-02-01

    Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

  20. Pärt: Fratres in sechs Versionen. Festina lente. Summa / C. S.

    Index Scriptorium Estoniae

    C. S.

    1997-01-01

    Uuest heliplaadist "Pärt: Fratres in sechs Versionen. Festina lente. Summa. Cantus in memoriam Benjamin Britten. Orchester der Ungarischen Staatsoper, Tamas Benedek". Naxos CD 8 553 750 (WD:79'06") DDD

  1. Lentes progressivas: análise da potência do astigmatismo induzido

    Directory of Open Access Journals (Sweden)

    Celso Marcelo Cunha

    2013-06-01

    Full Text Available OBJETIVO: Avaliar a potência do astigmatismo induzido nas lentes progressivas em um deflexômetro. MÉTODOS: Foram incluídas onze lentes progressivas com poder longe de +1,00D e adição 2,00D para perto. Avaliou-se o astigmatismo induzido em doze pontos do campo intermediário, sendo seis de cada lado do corredor progressivo no deflexômetro. RESULTADOS: Existem diferenças significativas entre as somas dos astigmatismos induzidos de cada lado do corredor progressivo e no total geral nestas lentes estudadas, com coeficiente de variação com forte dispersão (CV 10 a 13%. CONCLUSÃO: Existe uma variação importante das potências dos astigmatismos induzidos nas lentes progressivas.

  2. Multifocal hyperfunctioning thyroid carcinoma without metastases.

    Science.gov (United States)

    Nishida, Akiko T; Hirano, Shigeru; Asato, Ryo; Tanaka, Shinzo; Kitani, Yoshiharu; Honda, Nobumitsu; Fujiki, Nobuya; Miyata, Kouji; Fukushima, Hideyuki; Ito, Juichi

    2008-09-01

    Hyperthyroidism due to thyroid carcinoma is rare, and most cases are caused by hyperfunctioning metastatic thyroid carcinoma rather than primary carcinoma. Among primary hyperfunctioning thyroid carcinoma, multifocal thyroid carcinoma is exceedingly rare, with the only one case being reported in the literature. Here, we describe the case of a 62-year-old woman with multifocal functioning thyroid carcinoma. Technetium-99m (99m Tc) scintigraphic imaging showed four hot areas in the thyroid gland. Histopathological examination of all four nodules revealed papillary carcinoma, corresponding to hot areas in the 99m Tc scintigram. DNA sequencing of the thyrotropin receptor (TSH-R) gene from all nodules revealed no mutation, indicating that activation of TSH-R was unlikely in the pathophysiogenesis of hyperfunctioning thyroid carcinoma in the present case.

  3. Refractive outcomes after multifocal intraocular lens exchange.

    Science.gov (United States)

    Kim, Eric J; Sajjad, Ahmar; Montes de Oca, Ildamaris; Koch, Douglas D; Wang, Li; Weikert, Mitchell P; Al-Mohtaseb, Zaina N

    2017-06-01

    To evaluate the refractive outcomes after multifocal intraocular lens (IOL) exchange. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Retrospective case series. Patients had multifocal IOL explantation followed by IOL implantation. Outcome measures included type of IOL, surgical indication, corrected distance visual acuity (CDVA), and refractive prediction error. The study comprised 29 patients (35 eyes). The types of IOLs implanted after multifocal IOL explantation included in-the-bag IOLs (74%), iris-sutured IOLs (6%), sulcus-fixated IOLs with optic capture (9%), sulcus-fixated IOLs without optic capture (9%), and anterior chamber IOLs (3%). The surgical indication for exchange included blurred vision (60%), photic phenomena (57%), photophobia (9%), loss of contrast sensitivity (3%), and multiple complaints (29%). The CDVA was 20/40 or better in 94% of eyes before the exchange and 100% of eyes after the exchange (P = .12). The mean refractive prediction error significantly decreased from 0.22 ± 0.81 diopter (D) before the exchange to -0.09 ± 0.53 D after the exchange (P exchange to 0.23 D after the exchange (P exchange can be performed safely with good visual outcomes using different types of IOLs. A lower refractive prediction error and a higher likelihood of 20/40 or better vision can be achieved with the implantation of the second IOL compared with the original multifocal IOL, regardless of the final IOL position. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Basic characterization of normal multifocal electroretinogram

    International Nuclear Information System (INIS)

    Fernandez Cherkasova, Lilia; Rojas Rondon, Irene; Castro Perez, Pedro Daniel; Lopez Felipe, Daniel; Santiesteban Freixas, Rosaralis; Mendoza Santiesteban, Carlos E

    2008-01-01

    A scientific literature review was made on the novel multifocal electroretinogram technique, the involved cell mechanisms and some of the factors modifying its results together with the form of presentation. The basic characteristics of this electrophysiological record obtained from several regions of the retina of normal subjects is important in order to create at a small scale a comparative database to evaluate pathological eye tracing. All this will greatly help in early less invasive electrodiagnosis of localized retinal lesions. (Author)

  5. Chest wall resection for multifocal osseous haemangioma.

    Science.gov (United States)

    Weinandt, Marthe; Legras, Antoine; Mordant, Pierre; Le Pimpec Barthes, Françoise

    2016-02-01

    Intraosseous haemangioma is a rare and benign primary tumour of the bone. We report the case of a 76-year old woman who presented the exceptional condition of multifocal cavernous haemangiomas involving the spine and the ribs, requiring spinal and chest wall resections to confirm the diagnosis and treat the symptoms. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. [Multifocal Electroretinography in Patients with Poppers Maculopathy].

    Science.gov (United States)

    Pahlitzsch, Milena; Salchow, Daniel; Rossel, Mirjam; Bergholz, Richard

    2017-10-12

    Background Maculopathy is a potential side effect of amyl nitrite or "poppers" abuse. It is characterized by a sudden, painless decrease in visual acuity. While the funduscopic changes are subtle, optical coherence tomography shows alterations of the outer retinal layers in the fovea. However, the extent of retinal dysfunction remains poorly understood. Materials/Methods We compared the multifocal electroretinogram of 6 patients with poppers maculopathy to that of a control group consisting of 6 healthy subjects. Response densities and implicit times of N1 and P1 were analyzed. Results Response densities and implicit times of both N1 and P1 were lower in the patients with poppers maculopathy than in the control group, particularly in ring 1 and rings 4 and 5. The only statistically significant finding, however, was a reduced N1 response density of one hexagon in the patient group. No significant differences were found considering the sum response or the averaged rings 1 to 5. Conclusion Compared to a healthy control group, the multifocal electroretinogram of patients with poppers maculopathy shows no relevant impairment. This contrasts the marked effect of the disease on visual acuity. In clinical practice, poppers maculopathy cannot be diagnosed by multifocal electroretinography. Georg Thieme Verlag KG Stuttgart · New York.

  7. Lente fácica de câmara posterior para correção da miopia Posterior chamber phakic lens for the correction of myopia

    Directory of Open Access Journals (Sweden)

    Ricardo Queiroz Guimarães

    2001-02-01

    Full Text Available Objetivo: Avaliar a eficácia, previsibilidade e segurança do implante de lente intra-ocular de câmara posterior em pacientes com miopia moderada e elevada. Métodos: Analisamos os resultados das cirurgias realizadas em 93 olhos de 54 pacientes para implante de lente fácica de câmara posterior com a finalidade de corrigir miopia moderada e elevada. O objetivo da cirurgia era a emetropia. O acompanhamento médio foi de 9 meses, variando de 1 a 38 meses (desvio padrão 10,45. Resultados: O equivalente esférico médio pré-operatório era -13,56 D (variando de -5,75 a -20,38 D e o equivalente esférico médio pós-operatório no último exame foi -0,92 D (variando de -3,88 a +1,00 D. No último exame, 39 olhos (41,9% se encontravam entre ±0,50 D da emetropia, 64 olhos (68,8% estavam entre ±1,00 D e 88 olhos (94,6% estavam entre ±2,00 D da emetropia. Um ganho de duas ou mais linhas de visão foi observado em 45,17% (42 olhos. Em 15 olhos (16,1% ocorreu algum tipo de complicação: em 2 olhos (2,2% houve perda de células endoteliais, em 2 olhos (2,2% ocorreu bloqueio pupilar e em 11 olhos (11,8% houve alterações de transparência lenticular, assintomática em 5 olhos (5,4% e sintomática em 6 olhos (6,5%. Conclusão: O implante de lente fácica de câmara posterior para correção de miopia moderada e alta é um método eficaz, previsível e seguro. O significativo ganho de linhas de visão é uma observação freqüente nesta técnica. Um acompanhamento pós-operatório mais prolongado em um maior número de pacientes é necessário para confirmar a estabilidade dos resultados a longo prazo.Purpose: To examine the efficacy, predictability and safety of posterior chamber phakic intraocular lens implantation in patients with moderate and high myopia. Methods: We analyzed the results of 93 eyes of 54 patients who were submitted to the implantation of a posterior chamber phakic lens for the correction of their myopia. The target postoperative

  8. Optimizing outcomes with multifocal intraocular lenses

    Directory of Open Access Journals (Sweden)

    Gitansha Shreyas Sachdev

    2017-01-01

    Full Text Available Modern day cataract surgery is evolving from a visual restorative to a refractive procedure. The advent of multifocal intraocular lenses (MFIOLs allows greater spectacle independence and increased quality of life postoperatively. Since the inception in 1980s, MFIOLs have undergone various technical advancements including trifocal and extended depth of vision implants more recently. A thorough preoperative workup including the patients' visual needs and inherent ocular anatomy allows us to achieve superior outcomes. This review offers a comprehensive overview of the various types of MFIOLs and principles of optimizing outcomes through a comprehensive preoperative screening and management of postoperative complications.

  9. The Mathematical Theory of Multifocal Lenses

    Institute of Scientific and Technical Information of China (English)

    Jacob RUBINSTEIN

    2017-01-01

    This paper presents the fundamental optical concepts of designing multifocal ophthalmic lenses and the mathematical methods associated with them.In particular,it is shown that the design methodology is heavily based on differential geometric ideas such as Willmore surfaces.A key role is played by Hamilton's eikonal functions.It is shown that these functions capture all the information on the local blur and distortion created by the lenses.Along the way,formulas for computing the eikonal functions are derived.Finally,the author lists a few intriguing mathematical problems and novel concepts in optics as future projects.

  10. Imaging manifestations of progressive multifocal leukoencephalopathy

    International Nuclear Information System (INIS)

    Shah, R.; Bag, A.K.; Chapman, P.R.; Cure, J.K.

    2010-01-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunosuppressed patients. The diagnosis is usually suggested on imaging and confirmed by cerebrospinal fluid polymerase chain reaction (PCR) for JC virus DNA. In this article, we review the imaging manifestations of PML on computed tomography (CT), magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), MR spectroscopy, single photon-emission computed tomography (SPECT) and positron-emission tomography (PET), and outline the role of imaging in follow-up and prognostication.

  11. Light distribution in diffractive multifocal optics and its optimization.

    Science.gov (United States)

    Portney, Valdemar

    2011-11-01

    To expand a geometrical model of diffraction efficiency and its interpretation to the multifocal optic and to introduce formulas for analysis of far and near light distribution and their application to multifocal intraocular lenses (IOLs) and to diffraction efficiency optimization. Medical device consulting firm, Newport Coast, California, USA. Experimental study. Application of a geometrical model to the kinoform (single focus diffractive optical element) was expanded to a multifocal optic to produce analytical definitions of light split between far and near images and light loss to other diffraction orders. The geometrical model gave a simple interpretation of light split in a diffractive multifocal IOL. An analytical definition of light split between far, near, and light loss was introduced as curve fitting formulas. Several examples of application to common multifocal diffractive IOLs were developed; for example, to light-split change with wavelength. The analytical definition of diffraction efficiency may assist in optimization of multifocal diffractive optics that minimize light loss. Formulas for analysis of light split between different foci of multifocal diffractive IOLs are useful in interpreting diffraction efficiency dependence on physical characteristics, such as blaze heights of the diffractive grooves and wavelength of light, as well as for optimizing multifocal diffractive optics. Disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Lentes intraoculares fácicas de câmara posterior

    Directory of Open Access Journals (Sweden)

    Mara Barreto Theiss

    Full Text Available Resumo O objetivo deste artigo foi reunir estudos que reportam resultados disponíveis na literatura científica, considerando a previsibilidade, segurança, eficácia, e estabilidade das lentes intraoculares fácicas de câmara posterior. E relatar as complicações documentadas para estas lentes. A revisão criteriosa dos estudos publicados na literatura ate o momento revelam resultado satisfatórios quanto à eficácia, elevada previsibilidade, estabilidade e segurança do implante de lente intraocular de câmara posterior, para correção das miopia, hipermetropia e astigmatismo.

  13. Fatores técnicos intervenientes na realização do exame de eletrorretinograma multifocal (ERGmf Technical factors that influence multifocal electroretinogram (mfERG recording

    Directory of Open Access Journals (Sweden)

    Maria Kiyoko Oyamada

    2007-08-01

    Full Text Available OBJETIVO: Descrever os principais fatores intervenientes observados durante a aquisição e análise do exame de eletrorretinograma multifocal (ERGmf, que afetam o registro gráfico das ondas obtidas e portanto sua análise. MÉTODOS: Análise dos fatores de erro observados durante a aquisição de 100 exames seqüenciais de eletrorretinograma multifocal, realizados com o Reti System da Roland Consult, no período de maio a julho de 2005. Os exames de eletrorretinograma multifocal foram realizados conforme recomendações internacionais, respeitando-se os parâmetros preestabelecidos do equipamento, com 61 elementos, e ângulo visual de 30º. Todos os pacientes foram submetidos à avaliação oftalmológica completa, excluindo-se aqueles com transparência inadequada de meios, córneas planas e os incapazes de visualizar as linhas de fixação. RESULTADOS: Os fatores intervenientes, que poderiam causar erros na interpretação dos resultados obtidos, observados e corrigidos durante a realização dos exames foram: fixação excêntrica, movimentação dos olhos, contração do orbicular, contração da musculatura cervical, não-correção adequada, não-transparência adequada do eletrodo corneano, deslocamento do eletrodo em geral para baixo, descentralização do suporte da lente corretora, distância inadequada paciente-monitor em pacientes com alta ametropia, altura inadequada dos olhos em relação ao centro da tela, ruído na freqüência de 60 HZ (rede elétrica e de campo eletromagnético, impedâncias elevadas. No processamento das ondas, a utilização excessiva de filtros para remoção de ruídos dos registros obtidos, pode interferir na análise dos resultados obtidos. CONCLUSÕES: Cuidados simplesmente observacionais durante a aquisição dos sinais são de importância significativa para a obtenção de registros com boa morfologia e baixo nível de ruído. Permitindo, por meio de sua pronta correção, a análise correta e

  14. Multi-focal Vision and Gaze Control Improve Navigation Performance

    Directory of Open Access Journals (Sweden)

    Kolja Kuehnlenz

    2008-11-01

    Full Text Available Multi-focal vision systems comprise cameras with various fields of view and measurement accuracies. This article presents a multi-focal approach to localization and mapping of mobile robots with active vision. An implementation of the novel concept is done considering a humanoid robot navigation scenario where the robot is visually guided through a structured environment with several landmarks. Various embodiments of multi-focal vision systems are investigated and the impact on navigation performance is evaluated in comparison to a conventional mono-focal stereo set-up. The comparative studies clearly show the benefits of multi-focal vision for mobile robot navigation: flexibility to assign the different available sensors optimally in each situation, enhancement of the visible field, higher localization accuracy, and, thus, better task performance, i.e. path following behavior of the mobile robot. It is shown that multi-focal vision may strongly improve navigation performance.

  15. Bijdragen aan Hoofdstukken 2-6: Landschapsbiografie Dijkteruglegging Nijmegen-Lent

    NARCIS (Netherlands)

    Heunks, Eckhart

    2016-01-01

    Contributions to a synthesis of landscape archaeological activities carried out in Nijmegen-Lent as part of heritage management by Gemeente Nijmegen during expansion of the city and reconstruction of the Waal river dike and bridges in the past decade. In 2014-2015, Dr. Kim Cohen advised to the

  16. Implante de lente intraocular trifocal difractivo: análisis y resultado de la agudeza visual

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Ibáñez-Hernández

    2017-09-01

    Conclusiones: El implante de un lente intraocular trifocal difractivo es capaz de proporcionar una excelente visión lejana, intermedia y cercana, con escasas aberraciones ópticas, permitiendo una mejor calidad visual útil en actividades desarrolladas a diferentes distancias.

  17. Relationship between subcutaneous blood flow and absorption of lente type insulin

    DEFF Research Database (Denmark)

    Hildebrant, P; Mehlsen, J; Birch, K

    1987-01-01

    To study the relationship between the absorption of intermediate acting insulin and the local subcutaneous blood flow (SBF) 8 diabetic patients were given subcutaneous injections of 125I labeled human lente type insulin and 133Xenon in the abdominal wall. External measurements of the tracer...

  18. Lentes fáquicos como alternativa de tratamiento en el queratocono

    Directory of Open Access Journals (Sweden)

    Raúl Barroso Lorenzo

    Full Text Available El queratocono es una enfermedad degenerativa que se caracteriza por un adelgazamiento progresivo del estroma corneal y la deformidad en forma de cono de la córnea, lo cual provoca astigmatismo irregular y miopía elevada. Se realizó una revisión de artículos publicados referentes al implante de lentes intraoculares fáquicos como alternativa de tratamiento en esta entidad, la cual continúa siendo de difícil manejo en la actualidad. En ametropías con alto componente esférico y cilíndrico, el uso de lente fáquico tórico mostró óptimos resultados visuales. De igual modo el uso de lentes de soporte angular "estira" la córnea y achata el área apical central a través de sus hápticas, con lo que reduce la ectasia corneal y el astigmatismo irregular asimétrico. A su vez, la presencia del lente intraocular entre la pupila y la córnea crea una barrera física que evita la acción de la corriente de humor acuoso contra la córnea y, por consiguiente, hay una estabilización de todos los parámetros de la córnea después de la implantación del lente. La literatura reporta combinación de implantes de lentes fáquicos posterior a anillos intraestromales y crosslinking con un excelente resultado funcional: incrementa en forma importante la agudeza visual sin corrección, mejora las topografías corneales y las aberraciones de alto orden y disminuye la posibilidad de requerir un trasplante de córnea. El uso de lentes fáquicos tóricos en queratoconos estables es una alternativa terapéutica válida como tratamiento de la ametropía que acompaña a esta patología.

  19. Multifocal bilateral metatarsal tuberculosis: a rare presentation.

    Science.gov (United States)

    Vijay, Vipul; Sud, Alok; Mehtani, Anil

    2015-01-01

    Tuberculosis, or phthisis (consumption) as it was popularly known in the Greek era, has been endemic in Southeast Asia and Sub-Saharan Africa; however, the human immunodeficiency virus epidemic has seen the re-emergence of this disease in the areas in which it was not very commonly reported. With this, the need for understanding and treatment of rare presentations of tuberculosis has become of paramount importance to achieve the World Health Organization millennium goal of a "reversal of incidence by 2015." Foot involvement has been reported in 0.1% to 0.3% of extrapulmonary cases. Multifocal lesions have an incidence of histopathologic owing to the paucibacillary nature of the disease. Early identification and treatment with antitubercular drugs will normally result in a good cosmetic and functional result. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Multifocal Spinal Cord Nephroblastoma in a Dog.

    Science.gov (United States)

    Henker, L C; Bianchi, R M; Vargas, T P; de Oliveira, E C; Driemeier, D; Pavarini, S P

    2018-01-01

    A 1-year-old male American pit bull terrier was presented with a history of proprioceptive deficits and mild lameness of the right hindlimb, which progressed after 5 months to paraparesis, culminating in tetraparesis after 2 weeks. Necropsy findings were limited to the spinal cord and consisted of multiple, intradural, extramedullary, slightly red masses which produced segmental areas of medullary swelling located in the cervical intumescence, thoracolumbar column, sacral segment and cauda equina. Histological evaluation revealed a tumour, composed of epithelial, stromal and blastemal cells, with structures resembling tubules, acini and embryonic glomeruli. Immunohistochemical labelling for vimentin, cytokeratin and S100 was positive for the stromal, epithelial and blastemal cells, respectively. A final diagnosis of multifocal spinal cord nephroblastoma was established. This is the first report of such a tumour showing concomitant involvement of the cervicothoracic, thoracolumbar, sacral and cauda equina areas of the spinal cord. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Long-Term Visual Prognosis of Peripheral Multifocal Chorioretinitis

    NARCIS (Netherlands)

    Ossewaarde-van Norel, J; ten Dam-van Loon, NH; de Boer, JH; Rothova, A.

    2015-01-01

    Purpose To report on the clinical manifestations, complications, and long-term visual prognosis of patients with peripheral multifocal chorioretinitis and to search for predictors for a lower visual outcome. Design Retrospective consecutive observational case series. Methods setting: Institutional.

  2. Bilateral implantation of +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes

    NARCIS (Netherlands)

    Nuijts, Rudy M. M. A.; Jonker, Soraya M. R.; Kaufer, Robert A.; Lapid-Gortzak, Ruth; Mendicute, Javier; Martinez, Cristina Peris; Schmickler, Stefanie; Kohnen, Thomas

    2016-01-01

    To assess the clinical visual outcomes of bilateral implantation of Restor +2.5 diopter (D) multifocal intraocular lenses (IOLs) and contralateral implantation of a Restor +2.5 D multifocal IOL in the dominant eye and Restor +3.0 D multifocal IOL in the fellow eye. Multicenter study at 8

  3. Opacificación capsular posterior en lentes intraoculares hidrofílicos en comparación con lentes intraoculares hidrofóbicos usando imágenes de Scheimpflug

    Directory of Open Access Journals (Sweden)

    Arturo Olguin Manríquez

    2016-03-01

    Conclusiones: Los resultados de la función visual son comparables entre ambos lentes. La opacificación de la cápsula posterior se vio en menor proporción con el LIO Akreos MI60 cuando se midió por imágenes de Scheimpflug, debido probablemente al diseño del lente. No se demostraron correlación entre ambas pruebas.

  4. Diabetes mellitus y lentes de contacto Diabetes mellitus related to use of contact lenses

    Directory of Open Access Journals (Sweden)

    Beatriz Zozaya Aldana

    2009-04-01

    Full Text Available Cada día aumenta el número de diabéticos diagnosticados que demandan como método de compensación para los defectos de refracción las lentes de contacto. Debido a la escasa información que se tiene sobre el tema, dedicamos nuestro trabajo a realizar una revisión sobre la relación de estos dos temas: lentes de contacto y diabetes, con el justo ánimo de brindar una atención más completa a nuestros pacientes.Every day increases the figure of diagnosed diabetic patients requiring a compensatory method for refraction defects the use of contact lenses. Due to the non-available information on this matter, this paper is aimed to make a review on relation between these two topics: contact lenses and diabetes to offer a more complete care to our patients.

  5. CT and MRI in progressive multifocal leukoencephalopathy

    International Nuclear Information System (INIS)

    Lanfermann, H.; Heindel, W.; Schroeder, R.; Lackner, K.

    1994-01-01

    Radiological findings and course of progressive multifocal leukoencephalopathy in 14 patients (1 woman, 13 men; 13 HIV seropositive, 1 chronic lymphatic leukaemia) were analysed retrospectively and correlated with clinical symptoms. A total of 21 CT and 16 MRI studies were evaluated. CT scans and MR images of 9 patients, which had been obtained in less than two weeks, could be compared to each other. MRI was superior to CT: 6 lesions with a diameter of 1 cm and below were not detected on CT scans, in 5 patients the extent of lesions was underestimated. Cortical involvement, mass effect or signs of atrophy were missing. Only 1 of 65 lesions showed a tiny enhancement after Gd injection. Due to the pattern and spread of lesions, which showed a close correlation to the neurologic symptoms, three different types of PML are suggested: 1. Initial precentral demyelinisation with contralateral hemiparesis (n=8); 2. lesions in temporo-occipital locations with visual disturbances (n=2); 3. predominantly bilateral lesions of cerebellar white matter with ataxia (n=4). (orig.) [de

  6. Multifocal multiphoton microscopy with adaptive optical correction

    Science.gov (United States)

    Coelho, Simao; Poland, Simon; Krstajic, Nikola; Li, David; Monypenny, James; Walker, Richard; Tyndall, David; Ng, Tony; Henderson, Robert; Ameer-Beg, Simon

    2013-02-01

    Fluorescence lifetime imaging microscopy (FLIM) is a well established approach for measuring dynamic signalling events inside living cells, including detection of protein-protein interactions. The improvement in optical penetration of infrared light compared with linear excitation due to Rayleigh scattering and low absorption have provided imaging depths of up to 1mm in brain tissue but significant image degradation occurs as samples distort (aberrate) the infrared excitation beam. Multiphoton time-correlated single photon counting (TCSPC) FLIM is a method for obtaining functional, high resolution images of biological structures. In order to achieve good statistical accuracy TCSPC typically requires long acquisition times. We report the development of a multifocal multiphoton microscope (MMM), titled MegaFLI. Beam parallelization performed via a 3D Gerchberg-Saxton (GS) algorithm using a Spatial Light Modulator (SLM), increases TCSPC count rate proportional to the number of beamlets produced. A weighted 3D GS algorithm is employed to improve homogeneity. An added benefit is the implementation of flexible and adaptive optical correction. Adaptive optics performed by means of Zernike polynomials are used to correct for system induced aberrations. Here we present results with significant improvement in throughput obtained using a novel complementary metal-oxide-semiconductor (CMOS) 1024 pixel single-photon avalanche diode (SPAD) array, opening the way to truly high-throughput FLIM.

  7. 12 CFR 7.1003 - Money lent at banking offices or at other than banking offices.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Money lent at banking offices or at other than banking offices. 7.1003 Section 7.1003 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE... without violating 12 U.S.C. 36, 12 U.S.C. 81 and 12 CFR 5.30, provided that a third party is used to...

  8. Infiltrados corneales asociados al uso de lentes de contacto Corneal infiltrates associated with contact lens wear

    Directory of Open Access Journals (Sweden)

    Vivian Padrón Álvarez

    2001-12-01

    Full Text Available Se estudiaron 15 pacientes que usan lentes de contacto rígidas, permeables al gas (LCRPG y lentes de contacto blandas (LCB que presentaron infiltrados corneales. Se realizó estudio microbiológico de las lesiones y seguimiento clínico de estos casos. En 3 de los casos estudiados el cultivo fue positivo a estafilococo aureus, el resto de los estudios microbiológicos fueron negativos. Todos los pacientes respondieron rápidamente al retirar la lente de contacto y al tratamiento con antibióticos tópicos y ninguno tuvo afectación permanente de la agudeza visual. El diagnóstico exacto y el manejo apropiado de los infiltrados corneales en pacientes que usan lentes de contacto es de gran importancia por la posibilidad de infección o de secuela visual permanente.15 patients wearing gas permeable rigid contact lenses (GPRCL and soft contanct lenses (SCL that presented corneal infiltrates were studied. A microbiological study of the injuries and a clinical follow-up of these cases were conducted. In 3 of the studied cases the culture was positive to Staphyloccocus aureus. The rest of the mircobiological studies were negative. All the patients responded rapidly to the contact lens removal and to the treatment with topical antibiotics. None of them had permanent affection of visual acuity. The accurate diagnosis and the appropiate management of the corneal infiltrates in patients wearing contact lenses is very important due to the possibility of infection or of permanent visual sequela.

  9. Avaliação da qualidade de vida em pacientes submetidos à cirurgia de catarata, com implantes de lentes monofocais bifocais e multifocais

    Directory of Open Access Journals (Sweden)

    Beogival Wagner Lucas Santos

    2014-04-01

    Full Text Available Objetivo: Fornecer uma avaliação objetiva e subjetiva da qualidade de vida e o nível de satisfação de pacientes que se submeteram à cirurgia de catarata, com implante de lentes bifocais, multifocais e monofocais. Métodos: Lentes bifocais foram implantadas em 72 pacientes; lentes multifocais asférica em 16 pacientes; lentes multifocais apodizada em 20 pacientes e lentes monofocais em 63 pacientes. Foi aplicado um questionário de 47 perguntas cujos resultados foram avaliados e analisados. Resultados: O nível de satisfação dos pacientes implantados com lentes bifocais e multifocais foi significantemente mais alto do que aqueles com lentes monofocais (teste Kruskal-Wallis p<0,01, seguido do teste Dunn, p<0,05. Quanto à comparação de lentes monofocais com lentes bifocais e multifocais, a visão para perto sem correção foi consideravelmente mais baixa em pacientes com lentes monofocais (teste Z, p<0,001. Os pacientes com lentes monofocais sem correção apresentaram uma menor capacidade de ler jornais ou livros e no que diz respeito a trabalhos manuais do que aqueles com lentes bifocais e multifocais (teste Z, p<0,001. Conclusão: Os resultados deste estudo mostram que os pacientes que receberam as lentes bifocais e multifocais tiveram uma melhora notável em sua acuidade visual para perto, estando satisfeitos com sua visão geral, sem óculos. A satisfação foi atribuída ao fato de conseguirem ler livros e jornais, preencher cheques, preencher formulários, praticar esportes, se barbear ou se maquiar sem correção.

  10. The pathogenesis of progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Berger, Joseph R; Khalili, Kamel

    2011-12-01

    Interest in pathogenesis of progressive multifocal leukoencephalopathy (PML) followed the observation of the high risk for the disease in HIV infection and the recent observation of an association with a variety of newer therapeutic modalities, e.g., natalizumab, an α4β1 integrin inhibitor, and efalizumab, an anti-CD11a monoclonal antibody. Any hypothesis of PML pathogenesis must account for a number of facts. Firstly, the causative agent JC virus is ubiquitously present, yet only a vanishingly small number of infected persons develop the disease. Secondly, disorders of cell-mediated immunity increase the risk of the disease, particularly HIV infection. Impaired innate immunity is not a risk for PML, and antibodies against JC virus are not protective. Thirdly, a latent period of several months appears necessary following the administration of natalizumab and efalizumab before PML develops. Fourthly, restoration of the immune system can arrest the PML. It is possible that infection with JC virus occurs with a form of the virus shed in the urine of as many as 40% of all adults and present in sewage worldwide. Once acquired, perhaps through an oropharyngeal route, it may replicate and disseminate. A neurotropic form of JC virus that replicates in glial tissues causes PML when immunosurveillance is impaired. There are many unanswered questions with respect to PML pathogenesis. How is virus acquired? What tissues are infected? What is the origin of the neurotropic form? When does virus enter brain? What is the role of central nervous system immunosurveillance? The lack of an animal model has made answering these questions challenging. © Discovery Medicine

  11. Progressive multifocal leukoencephalopathy after fingolimod treatment.

    Science.gov (United States)

    Berger, Joseph R; Cree, Bruce A; Greenberg, Benjamin; Hemmer, Bernhard; Ward, Brian J; Dong, Victor M; Merschhemke, Martin

    2018-04-18

    We describe the characteristics of the 15 patients with fingolimod-associated progressive multifocal leukoencephalopathy (PML) identified from the Novartis data safety base and provide risk estimates for the disorder. The Novartis safety database was searched for PML cases with a data lock point of August 31, 2017. PML classification was based on previously published criteria. The risk and incidence were estimated using the 15 patients with confirmed PML and the overall population of patients treated with fingolimod. As of August 31, 2017, 15 fingolimod-treated patients had developed PML in the absence of natalizumab treatment in the preceding 6 months. Eleven (73%) were women and the mean age was 53 years (median: 53 years). Fourteen of the 15 patients were treated with fingolimod for >2 years. Two patients had confounding medical conditions. Two patients had natalizumab treatment. This included one patient whose last dose of natalizumab was 3 years and 9 months before the diagnosis of PML. The second patient was receiving fingolimod for 4 years and 6 months, which was discontinued to start natalizumab and was diagnosed with PML 3 months after starting natalizumab. Absolute lymphocyte counts were available for 14 of the 15 patients and none exhibited a sustained grade 4 lymphopenia (≤200 cells/μL). The risk of PML with fingolimod in the absence of prior natalizumab treatment is low. The estimated risk was 0.069 per 1,000 patients (95% confidence interval: 0.039-0.114), and the estimated incidence rate was 3.12 per 100,000 patient-years (95% confidence interval: 1.75-5.15). Neither clinical manifestations nor radiographic features suggested any unique features of fingolimod-associated PML. © 2018 American Academy of Neurology.

  12. Intra-ocular lens implantation after vitreous loss.

    Directory of Open Access Journals (Sweden)

    Shah N

    1991-10-01

    Full Text Available Vitreous loss is a dreaded complication of cataract surgery, especially so with IOL implant which then may have to be abandoned. Thirty three cases of IOL implants, either anterior chamber or posterior chamber, after vitreous loss done in the past 3 years were studied. Of these, 18 (55% had a final visual acuity of 6/18 or better and none was worse than 6/60. The postoperative complications and findings and a review of literature are discussed.

  13. Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

    NARCIS (Netherlands)

    van der Linden, Jan Willem; Vrijman, Violette; Al-Saady, Rana; El-Saady, Rana; van der Meulen, Ivanka J.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

    2014-01-01

    To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312

  14. A rare case of a medullary, multifocal lesion in the distal radius

    Science.gov (United States)

    Aktas, Birol; Ozturan, Burak; Kilic, Bulent; Ozkan, Korhan

    2017-01-01

    In multifocal findings, the possibility of multifocal osteoid osteomas should be considered and this case helps us to be attentive for the unusual radiographical presentation of osteoid osteoma. PMID:28748099

  15. Scleral fixation of a single-piece multifocal intraocular lens.

    Science.gov (United States)

    Can, Ertugrul; Basaran, M Resat; Gül, Adem

    2013-01-01

    We describe an ab interno technique for injector implantation of a one-piece multifocal intraocular lens (IOL). Transscleral fixation of multifocal posterior chamber IOL implantation using an injector with ab interno technique was performed in an eye of a 9-year-old girl who had undergone pars plana lensectomy 2 years before for bilateral lens subluxation with unknown etiology. No major complications were encountered during a 3-month follow-up of the patient and excellent centration was observed during the follow-up period. Her preoperative best spectacle-corrected distance visual acuity of 20/32 improved to uncorrected distance visual acuity of 20/25. Closed-loop design of IOL served the function of eyelets and position of the IOL was provided using only a 2-point fixation. Intraoperative position adjustment of the IOL provided an excellent centralization of multifocal IOL.

  16. Research advances on multifocal electroretinogram in primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Feng-Fei Mo

    2013-10-01

    Full Text Available Primary open angle glaucoma is a chronic and progressive optic neuropathy. It can lead to serious damage of visual impairment, and it is an important eye disease of blindness. Multifocal electroretinogram is a new way to measure visual electrophysiology. It can measure electroretinogram of the whole visual field of many small parts in a relatively short period of time, and it can reflect the function of regional retina. It has an extremely important value for early diagnosis of primary open angle glaucoma. The research advances on multifocal electroretinogram in diagnosing primary open angle glaucoma were summarized in this paper.

  17. Multifocal osteosarcoma as second tumor after childhood retinoblastoma

    International Nuclear Information System (INIS)

    Potepan, P.; Laffranchi, A.; Danesini, G.M.; Spagnoli, I.; Luksch, R.; Sozzi, G.; Testi, A.; Parafioriti, A.; Giardini, R.

    1999-01-01

    We present a case of multifocal osteosarcoma (MFOS) arising 11.5 years after successful treatment of bilateral retinoblastoma. The clinical, imaging and pathological findings at onset, after therapy, and during follow-up are described. Fluorescent in situ hybridization did not reveal a deletion of the RB-1 retinoblastoma gene, although the presence of an inactivating mutation invisible to this method cannot be ruled out. The MFOS may have been a second multifocal tumor associated with the original retinoblastoma or a post-irradiation sarcoma with extensive metastases. (orig.)

  18. Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

    Science.gov (United States)

    Pavlidis, Mitrofanis; de Ortueta, Diego; Scharioth, Gabor B

    2011-05-01

    To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus. A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus. Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis. Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction. Copyright 2011, SLACK Incorporated.

  19. Multifocal Synchronous Granular Cell Tumors of the Gastrointestinal Tract

    OpenAIRE

    Lipkin-Moore, Zachary; Thomas, Rebecca M.; Rothstein, Robin D.

    2014-01-01

    Granular cell tumors (GCT) are rare and unusual tumors, which are usually benign and asymptomatic. Only 5?10% of cases involve the gastrointestinal tract, most commonly as singular, non-cancerous lesions in the esophagus. We report a rare case of symptomatic, multifocal, synchronous GCT involving the esophagus, stomach, and cecum.

  20. Multifocal versus monofocal intraocular lenses after cataract extraction

    Directory of Open Access Journals (Sweden)

    Daniel Calladine

    Full Text Available BACKGROUND: Good unaided distance visual acuity is now a realistic expectation following cataract surgery and intraocular lens (IOL implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs. OBJECTIVES: The objective of this review was to assess the effects of multifocal IOLs, including effects on visual acuity, subjective visual satisfaction, spectacle dependence, glare and contrast sensitivity, compared to standard monofocal lenses in people undergoing cataract surgery. METHODS: Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register, The Cochrane Library 2012, Issue 2, MEDLINE (January 1946 to March 2012, EMBASE (January 1980 to March 2012, the metaRegister of Controlled Trials (mRCT (www.controlled-trials.com, ClinicalTrials.gov (www.clinicaltrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP (www.who.int/ictrp/search/en. We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 6 March 2012. We searched the reference lists of relevant articles and contacted investigators of included studies and manufacturers of multifocal IOLs for information about additional published and unpublished studies. Selection criteria: All randomised controlled trials comparing a multifocal IOL of any type with a monofocal IOL as control were included. Both unilateral and bilateral implantation trials were included. Data collection and analysis: Two authors collected data and assessed trial quality. Where possible, we pooled data from the individual studies using a random-effects model, otherwise we tabulated data. MAIN RESULTS: Sixteen completed trials

  1. Does multifocal papillary micro-carcinoma require radioiodine ablation?

    International Nuclear Information System (INIS)

    Punda, A.; Markovic, V.; Eterovic, D.

    2015-01-01

    Full text of publication follows. Background: the thyroid carcinomas smaller than 1 cm (micro-carcinomas) comprise a significant fraction of papillary carcinomas. Excluding clinical micro-carcinomas, which present as metastatic disease, the micro-carcinomas diagnosed by ultrasound/FNAC or incidentally have very good prognosis. However, whether or not these papillary micro-carcinomas require post-surgical radioiodine ablation remains a matter of debate. Hypothesis: multi-focality is present in majority of clinical papillary micro-carcinomas and this characteristic can be used to identify the subset of non-clinical micro-carcinomas with greater malignant potential. Methods: the data on types of differentiated thyroid carcinomas diagnosed in the period 2008-2011 in the University Hospital Split were collected. Results: there were 359 patients with thyroid carcinoma, 329 (92%) of which had papillary carcinoma. About 61% (202/329) of papillary carcinomas were micro-carcinomas; most of them were diagnosed by ultrasound/FNAC (134/202= 66%), the rest were incidentalomas (48/202=24%) and clinical micro carcinomas (20/202=10%). Sixty percent (12/20) of patients with clinical micro-carcinoma and 23 patients with non-clinical micro-carcinoma (23/182=13%) had multifocal disease. Conclusion: multifocal disease is a frequent characteristic of clinical papillary thyroid micro-carcinomas, suggesting that multi-focality presents an early stage of non-clinical micro-carcinomas with more aggressive behaviour. Thus multifocal, but not uni-focal papillary micro-carcinomas may require radioiodine ablation. (authors)

  2. Power profiles of single vision and multifocal soft contact lenses.

    Science.gov (United States)

    Wagner, Sandra; Conrad, Fabian; Bakaraju, Ravi C; Fedtke, Cathleen; Ehrmann, Klaus; Holden, Brien A

    2015-02-01

    The purpose of this study was to investigate the optical zone power profile of the most commonly prescribed soft contact lenses to assess their potential impact on peripheral refractive error and hence myopia progression. The optical power profiles of six single vision and ten multifocal contact lenses of five manufacturers in the powers -1.00 D, -3.00 D, and -6.00 D were measured using the SHSOphthalmic (Optocraft GmbH, Erlangen, Germany). Instrument repeatability was also investigated. Instrument repeatability was dependent on the distance from the optical centre, manifesting unreliable data for the central 1mm of the optic zone. Single vision contact lens measurements of -6.00 D lenses revealed omafilcon A having the most negative spherical aberration, lotrafilcon A having the least. Somofilcon A had the highest minus power and lotrafilcon A the biggest deviation in positive direction, relative to their respective labelled powers. Negative spherical aberration occurred for almost all of the multifocal contact lenses, including the centre-distance designs etafilcon A bifocal and omafilcon A multifocal. Lotrafilcon B and balafilcon A seem to rely predominantly on the spherical aberration component to provide multifocality. Power profiles of single vision soft contact lenses varied greatly, many having a negative spherical aberration profile that would exacerbate myopia. Some lens types and powers are affected by large intra-batch variability or power offsets of more than 0.25 dioptres. Evaluation of power profiles of multifocal lenses was derived that provides helpful information for prescribing lenses for presbyopes and progressing myopes. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  3. Assessment of morbidity in carcinoma of the cervix: a comparison of the LENT SOMA scales and the Franco-Italian glossary

    International Nuclear Information System (INIS)

    Davidson, Susan E.; Burns, Meriel P.; Routledge, Jacqueline A.; Swindell, Ric; Bentzen, Soeren M.; West, Catharine M.L.

    2003-01-01

    Background and purpose: To assess the correlation between the LENT (late effects on normal tissue) SOMA (subjective objective management analytic) system and the Franco-Italian glossary scores of late morbidity in cervical cancer patients treated with radiation, and to compare the ability of the scoring systems to detect differences between radiation treatment groups. Materials and methods: The study was retrospective. Patients, invited to take part in the study, had radiotherapy for cervical cancer and had a minimum of 3 years follow-up with no evidence of recurrence. One hundred patients agreed to take part. LENT subjective data were obtained using a patient questionnaire approach in order to complete the scales as published. The LENT objective, management and Franco-Italian glossary scores were obtained by a physician. Correlations between scores and differences between treatment groups were examined using non-parametric tests. Results: The average LENT SOMA scores had a greater resolution than the maximum scores, and using the maximum score alone underestimated treatment morbidity. The Franco-Italian glossary scores correlated strongly with the LENT objective scores (ρ=0.61, P<0.0005), and less strongly with the LENT subjective scores (ρ=0.45, P<0.0005). Significant differences in morbidity between the radiation treatment groups were measured using both the LENT SOMA system and the Franco-Italian glossary. Conclusions: The maximum and average LENT scores should be reported for each subsite. The LENT objective scores correlated well with the scores obtained using the established Franco-Italian glossary, but the LENT system provided additional information on subjective treatment effects. Both systems were able to measure significant differences in morbidity between radiation treatment groups. In conclusion, the LENT SOMA system is a valid and comprehensive approach for scoring the late normal tissue effects of radiotherapy

  4. Adaptação de lente de contato gelatinosa especial para ceratocone Keratoconus special soft contact lens fitting

    Directory of Open Access Journals (Sweden)

    Ester Sakae Yamazaki

    2006-08-01

    Full Text Available OBJETIVO: Relatar a experiência inicial com o uso de lentes de contato gelatinosas especiais para ceratocone. MÉTODOS: Estudo retrospectivo de 80 olhos de 66 pacientes usuários de lentes de contato gelatinosas especial para ceratocone, no Setor de Lentes de Contato da UNIFESP e em clínicas particulares. Os pacientes foram classificados de acordo com o grau de gravidade da doença pela avaliação ceratométrica. Foram coletados os seguintes dados: idade, sexo, diagnóstico, ceratometria, acuidade visual com a lente, equivalente esférico (ES, curvatura da lente e indicação para o seu uso. RESULTADOS: Foram estudados 80 olhos de 66 pacientes usuários de lente gelatinosa para ceratocone. A média de idade foi de 29 anos, sendo 51,5% homens e 48,5% de mulheres. De acordo com os grupos: incipiente: 15,0%, moderado: 53,7%, avançado: 26,3%, grave: 5,0%. A maioria dos olhos estudados (91,25% apresentou acuidade visual melhor que 20/40 com a lente. Foram adaptadas 58% lentes de poder esférico (média de -5,45 dioptrias e 41% lentes com grau esferocilíndrico (variando de -0,50 a -5,00 dioptrias cilíndricas. A curva esférica mais utilizada foi de 7,6 mm (61% dos olhos. As principais razões para a escolha e adaptação desta lente foram devido à intolerância e ao padrão de adaptação insatisfatório com outras lentes. CONCLUSÃO: A lente gelatinosa para ceratocone pode ser usada em casos de difícil adaptação, como uma opção para melhorar o conforto e possibilitar a reabilitação visual em pacientes que não obtiveram alternativas a não ser algum procedimento cirúrgico.PURPOSE: To evaluate the fitting and use of a soft contact lens in keratoconic patients. METHODS: Retrospective study on 80 eyes of 66 patients, fitted with a special soft contact lens for keratoconus, at the Contact Lens Section of UNIFESP and private clinics. Keratoconus was classified according to degrees of disease severity by keratometric pattern. Age, gender

  5. Cálculo del poder de la lente intraocular mediante biometría ultrasónica

    Directory of Open Access Journals (Sweden)

    Yileika Elías García

    Full Text Available Objetivo: caracterizar el comportamiento del cálculo de la lente intraocular mediante biometría ultrasónica. Métodos: se realizó un estudio descriptivo y prospectivo, con un grupo de pacientes atendidos por el Servicio de Catarata del Centro Oftalmológico «Enrique Cabrera», que recibieron tratamiento quirúrgico por catarata con implante de lente intraocular, mediante técnica de Blumenthal. La muestra se conformó con 160 ojos y se estudiaron las variables: sorpresa refractiva, edad, longitud axial y promedio queratométrico según resultado refractivo, poder dióptrico de la lente y componente esférico según edad. Resultados: como resultados más sobresalientes, se obtuvo que el 78,7 % no presentó error en el cálculo de la lente, la mayoría de los pacientes tenían 60 años y más, predominó el rango de longitud axial entre 22 y 24,4 (67,5 %, el promedio queratométrico de 43 a 44,99 (64,3 %, el poder dióptrico del lente de + 20 a + 23 dioptrías (48,2 % y el componente esférico entre 0,00 y +/-1,00 dioptrías (78,8%. Conclusiones: se considera que la biometría ultrasónica resulta adecuada para el cálculo correcto del lente.

  6. Contact lens-associated microbial keratitis Ceratites microbianas relacionadas a lente de contato

    Directory of Open Access Journals (Sweden)

    Aline Silveira Moriyama

    2008-12-01

    Full Text Available PURPOSE: Contact lens-associated microbial keratitis is a severe condition with sight-threatening potential and increasing incidence. Information regarding the etiological agents is essential in guiding management and may vary geographically. The aim of this study was to analyze the microbiological results of corneal scrapings collected from patients presenting with contact lens-associated microbial keratitis. METHODS: Retrospective analysis of the records of all patients who were clinically diagnosed with contact lens-associated microbial keratitis and had corneal scrapings sent to the Laboratory of Ocular Microbiology, UNIFESP/EPM during a 5-year period from January 2002 to December 2007. RESULTS: The etiological agent was identified in 239 patients. Bacterial isolates accounted for 166 (69.46% cases, Acanthamoeba for 95 (39.75% cases and fungi for 4 (1.67% cases. Among the bacterial infections, coagulase-negative Staphylococcus was demonstrated in 74 cases, while Pseudomonas spp was found in 32 patients. All coagulase negative Staphylococcus and Pseudomonas were susceptible to ciprofloxacin and ofloxacin. Resistance to gentamicin was documented in a single case of Pseudomonas. Fourth-generation flouoroquinolone resistance was not observed among Pseudomonas cases. CONCLUSION: Coagulase-negative Staphylococcus was the most frequent isolate, and such data must be considered when determining empiric treatment. Second-generation fluoroquinolones ciprofloxacin and ofloxacin and fourth-generation fluoroquinolones moxifloxacin and gatifloxacin showed a good antibacterial profile and therefore could be good options for initial management.OBJETIVO: A ceratite microbiana associada ao uso de lente de contato é uma condição clínica grave, com risco de perda visual e cuja incidência vem aumentando progressivamente. Os principais agentes etiológicos podem variar geograficamente e informações referentes aos agentes causais são essenciais para

  7. Lentes fácicas de câmara anterior

    Directory of Open Access Journals (Sweden)

    Walton Nosé

    2012-08-01

    Full Text Available Os implantes em olhos fácicos apresentam-se como uma opção para a correção de altas ametropias. De acordo com sua localização podem ser classificados como de câmara anterior ou posterior, sendo que os primeiros subdividem-se em fixação iriana ou de suporte angular. Além da correção da miopia, as lentes de fixação iriana apresentam modelos para hipermétropes e astigmatas. Várias modificações no desenho das lentes foram propostas nas últimas décadas com a finalidade de reduzir complicações tardias, como a perda endotelial progressiva. Cuidados no intraoperatório devem ser tomados de forma a diminuir a perda endotelial aguda relacionada ao trauma. Avanços nos métodos de triagem pré-operatória também melhoraram a segurança do procedimento. A estimativa do poder dióptrico é baseada nos cálculos de Van der Heijde, sendo dependente da profundidade de câmara anterior, do equivalente esférico da refração e da média ceratométrica. Resultados a longo prazo demonstram a eficácia, previsibilidade e segurança do procedimento. Dependendo do modelo, além da possibilidade de perda endotelial, outras possíveis complicações incluem: irite, dispersão pigmentar, atrofia de íris, ovalização pupilar, rotação, descentração ou deslocamento da lente, hipertensão ocular e bloqueio pupilar. Modelos dobráveis atualmente disponíveis vêm apresentado resultados bastante promissores com redução da taxa de complicações.

  8. A Rare Case of Multifocal Prostatic Blue Nevus

    Directory of Open Access Journals (Sweden)

    Elias J. Farran

    2018-01-01

    Full Text Available Prostatic blue nevus is a rare benign pathologic diagnosis most commonly diagnosed incidentally on many different types of prostate specimens. Blue nevus is the deposition of stromal melanin characterized by spindle cells within the fibromuscular stroma which stains positive for melanin-specific stains Fontana-Masson and S100 and stains negative for CD68, HMB45, and iron stains. We report the case of a multifocal and bilateral blue nevus in a 52-year-old Hispanic male who presented with an elevated prostate-specific antigen of 4.3 and mild obstructive lower urinary tract symptoms, found by transrectal ultrasound-guided prostate needle biopsy. The biopsy also revealed benign prostatic tissue with postatrophic hyperplasia and chronic inflammation. This is the 35th reported case of prostatic blue nevus and the third to show multifocal blue nevus.

  9. A circular multifocal collimator for 3D SPECT imaging

    International Nuclear Information System (INIS)

    Guillemaud, R.; Grangeat, P.

    1993-01-01

    In order to improve sensitivity of 3D Single Photon Emission Tomography (SPECT) image, a cone-beam collimator can be used. A new circular multifocal collimator is proposed. The multiple focal points are distributed on a transaxial circle which is the trajectory of the focal points during the circular acquisition. This distribution provides a strong focusing at the center of the detector like a cone-beam collimator, with a good sensitivity, and a weak transaxial focusing at the periphery. A solution for an analytical multifocal reconstruction algorithm has been derived. Grangeat algorithm is proposed to use for this purpose in order to reconstruct with a good sensitivity the region of interest. (R.P.) 3 refs

  10. Multifocal epithelioid hemangioendothelioma of the phalanges of the hand

    International Nuclear Information System (INIS)

    Bruegel, Melanie; Waldt, Simone; Woertler, Klaus; Rummeny, Ernst J.; Weirich, Gregor

    2006-01-01

    Epithelioid hemangioendothelioma (EH) of bone is a rare vascular neoplasm characterized by epithelioid endothelial cells and a variable biologic behaviour. The principal sites of occurrence of this osteolytic tumor are the lower extremity and the axial skeleton. Approximately half of the cases present with multifocal disease. The latter feature can be helpful in suggesting the diagnosis of a vascular tumor; on the other hand, it strengthens the need for a skeletal survey or whole-body MRI/CT. We report on the clinical, histologic and radiologic features - including CT and MRI findings - of EH in a case of multifocal disease of the phalanges of the hand, a very uncommon anatomic site of affliction. (orig.)

  11. Multifocal visual evoked responses to dichoptic stimulation using virtual reality goggles: Multifocal VER to dichoptic stimulation.

    Science.gov (United States)

    Arvind, Hemamalini; Klistorner, Alexander; Graham, Stuart L; Grigg, John R

    2006-05-01

    Multifocal visual evoked potentials (mfVEPs) have demonstrated good diagnostic capabilities in glaucoma and optic neuritis. This study aimed at evaluating the possibility of simultaneously recording mfVEP for both eyes with dichoptic stimulation using virtual reality goggles and also to determine the stimulus characteristics that yield maximum amplitude. ten healthy volunteers were recruited and temporally sparse pattern pulse stimuli were presented dichoptically using virtual reality goggles. Experiment 1 involved recording responses to dichoptically presented checkerboard stimuli and also confirming true topographic representation by switching off specific segments. Experiment 2 involved monocular stimulation and comparison of amplitude with Experiment 1. In Experiment 3, orthogonally oriented gratings were dichoptically presented. Experiment 4 involved dichoptic presentation of checkerboard stimuli at different levels of sparseness (5.0 times/s, 2.5 times/s, 1.66 times/s and 1.25 times/s), where stimulation of corresponding segments of two eyes were separated by 16.7, 66.7,116.7 & 166.7 ms respectively. Experiment 1 demonstrated good traces in all regions and confirmed topographic representation. However, there was suppression of amplitude of responses to dichoptic stimulation by 17.9+/-5.4% compared to monocular stimulation. Experiment 3 demonstrated similar suppression between orthogonal and checkerboard stimuli (p = 0.08). Experiment 4 demonstrated maximum amplitude and least suppression (4.8%) with stimulation at 1.25 times/s with 166.7 ms separation between eyes. It is possible to record mfVEP for both eyes during dichoptic stimulation using virtual reality goggles, which present binocular simultaneous patterns driven by independent sequences. Interocular suppression can be almost eliminated by using a temporally sparse stimulus of 1.25 times/s with a separation of 166.7 ms between stimulation of corresponding segments of the two eyes.

  12. Lentes progressivas: análise dos campos intermediário e de perto por deflexometria

    Directory of Open Access Journals (Sweden)

    Celso Marcelo Cunha

    2013-02-01

    Full Text Available OBJETIVO: Avaliar por deflexometria as diferentes regiões das lentes progressivas e determinar as áreas dos campos de visão intermediário e de perto. MÉTODOS: Foram incluídas vinte e duas lentes progressivas com poder +1,00 DE para longe e duas adições diferentes (adição 1,00 e 2,00, 11 de cada. Mediram-se as áreas dos campos intermediário e de perto entre as isoastigmáticas de 0,5 DC. RESULTADOS: Encontraram-se diferenças significativas entre as áreas dos campos intermediário e de perto das lentes estudadas. Entre a área do campo intermediário e a adição observou-se correlação inversa; entre a área do campo intermediário e a extensão vertical do corredor encontrou-se correlação direta. CONCLUSÃO: Com esses dados permitem-se recomendar as lentes de acordo com o campo de maior necessidade visual de cada usuário.

  13. [Multifocal phakic intraocular lens implant to correct presbyopia].

    Science.gov (United States)

    Baikoff, G; Matach, G; Fontaine, A; Ferraz, C; Spera, C

    2005-03-01

    Presbyopic surgery is considered as the new frontier in refractive surgery. Different solutions are proposed: myopization of one eye, insertion of an accommodative crystalline lens, scleral surgery, the effects of which are still unknown, and finally multifocal phakic implants. We therefore decided to undertake a prospective study under the Huriet law to determine its efficacy and specify the conditions required for an anterior chamber multifocal phakic implant. Fifty-five eyes of 33 patients received an anterior chamber foldable multifocal phakic implant. Twenty-one females and 12 males underwent surgery. Initial refraction was between -5D and +5D. The implant's single addition was +2.50. Recuperating a distant uncorrected visual acuity of 0.6 or better and near uncorrected vision of Parinaud 3 or better can be considered a very good postoperative result. Average follow-up was 42.6+/-18 weeks. Mean postoperative refraction was -0.12+/-0.51 D. Mean postoperative uncorrected visual acuity was 0.78+/-0.20. Postoperative uncorrected visual acuity was Parinaud 2.3+/-0.6. Eighty-four percent of eyes operated on recuperated 0.6 or better without correction and Parinaud 3 or better without correction. Lenses in four eyes were explanted for different reasons, essentially optical, and no severe anatomical complications were observed. Placing an anterior chamber multifocal phakic implant to correct presbyopia is an effective technique with good predictability and has the advantage of being reversible in case of intolerance, optical parasite effects or undesired complications. Considering the particularity of this surgery, it is imperative to respect very strict inclusion criteria: anterior chamber depth equal to or above 3.1 mm, open angle, endothelial cell count equal to or above 2000 cells/mm2, absence of an incipient cataract or the slightest evidence of macular alteration.

  14. The multifocal electroretinogram (mfERG) in the pig

    DEFF Research Database (Denmark)

    Voss Kyhn, Maria; Kiilgaard, Jens Folke; Lopez, Ana Garcia

    2007-01-01

    To establish a method allowing multifocal electroretinography (mfERG) recording with simultaneous fundus monitoring on anaesthetized pigs. In addition we characterize the peaks of the porcine mfERG trace, and compare the visual streak area with the optic nerve head, a known non-response area....... Finally we illustrate the feasibility of the method by performing mfERG after an induced laser burn in the visual streak....

  15. Retreatments after multifocal intraocular lens implantation: an analysis

    Directory of Open Access Journals (Sweden)

    Gundersen KG

    2016-03-01

    Full Text Available Kjell Gunnar Gundersen,1 Sarah Makari,2 Steffen Ostenstad,1 Rick Potvin2 1Ifocus Eye Clinic, Haugesund, Norway; 2Science in Vision, Akron, NY, USA Purpose: To determine the incidence and etiology of required retreatment after multifocal intraocular lens (IOL implantation and to evaluate the methods and clinical outcomes of retreatment.Patients and methods: A retrospective chart review of 416 eyes of 209 patients from one site that underwent uncomplicated cataract surgery with multifocal IOL implantation. Biometry, the IOL, and refractive data were recorded after the original implantation, with the same data recorded after retreatment. Comments related to vision were obtained both before and after retreatment for retreated patients.Results: The multifocal retreatment rate was 10.8% (45/416 eyes. The eyes that required retreatment had significantly higher residual refractive astigmatism compared with those who did not require retreatment (1.21±0.51 D vs 0.51±0.39 D, P<0.01. The retreatment rate for the two most commonly implanted primary IOLs, blended bifocal (10.5%, 16/152 and bilateral trifocal (6.9%, 14/202 IOLs, was not statistically significantly different (P=0.12. In those requiring retreatment, refractive-related complaints were most common. Retreatment with refractive corneal surgery, in 11% of the eyes, and piggyback IOLs, in 89% of the eyes, was similarly successful, improving patient complaints 78% of the time.Conclusion: Complaints related to ametropia were the main reasons for retreatment. Residual astigmatism appears to be an important determinant of retreatment rate after multifocal IOL implantation. Retreatment can improve symptoms for a high percentage of patients; a piggyback IOL is a viable retreatment option. Keywords: piggyback IOL, Sulcoflex, toric, STAAR, symptoms, astigmatism

  16. Multifocal amelanotic conjunctival melanoma and acquired melanosis sine pigmento.

    Science.gov (United States)

    Paridaens, A D; McCartney, A C; Hungerford, J L

    1992-03-01

    Clinical and histopathological features of four cases of multifocal amelanotic malignant melanoma of the conjunctiva in association with 'acquired melanosis sine pigmento' are reported. The absence of conjunctival pigmentation in this extremely rare combination of lesions prevented early diagnosis and clinical monitoring. As a result orbital exenteration was required in three cases. This multicentric non-pigmented variety of conjunctival malignant melanoma tends to present later than pigmented forms and may require exenteration of the orbit as a primary procedure.

  17. Primary multifocal tuberculous osteomyelitis with involvement of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Chang, D.S. [New York University School of Medicine, New York, New York (United States); Rafii, M.; McGuinness, G. [Department of Radiology, NYU Medical Center, New York, NY (United States); Jagirdar, J.S. [Department of Pathology, NYU Medical Center, New York, New York (United States)

    1998-11-01

    Two cases of primary multifocal tuberculous osteomyelitis with involvement of the rib cage are presented. The lungs were normal and the appearance of the skeletal lesions did not suggest tuberculosis. These lesions were predominantly lytic, with minimal soft tissue involvement. Tuberculosis should be high in the differential diagnosis of multiple destructive bone lesions, especially in patients from regions where tuberculosis is endemic. (orig.) With 5 figs., 21 refs.

  18. Heterogeneity of DNA methylation in multifocal prostate cancer.

    Science.gov (United States)

    Serenaite, Inga; Daniunaite, Kristina; Jankevicius, Feliksas; Laurinavicius, Arvydas; Petroska, Donatas; Lazutka, Juozas R; Jarmalaite, Sonata

    2015-01-01

    Most prostate cancer (PCa) cases are multifocal, and separate foci display histological and molecular heterogeneity. DNA hypermethylation is a frequent alteration in PCa, but interfocal heterogeneity of these changes has not been extensively investigated. Ten pairs of foci from multifocal PCa and 15 benign prostatic hyperplasia (BPH) samples were obtained from prostatectomy specimens, resulting altogether in 35 samples. Methylation-specific PCR (MSP) was used to evaluate methylation status of nine tumor suppressor genes (TSGs), and a set of selected TSGs was quantitatively analyzed for methylation intensity by pyrosequencing. Promoter sequences of the RASSF1 and ESR1 genes were methylated in all paired PCa foci, and frequent (≥75 %) DNA methylation was detected in RARB, GSTP1, and ABCB1 genes. MSP revealed different methylation status of at least one gene in separate foci in 8 out of 10 multifocal tumors. The mean methylation level of ESR1, GSTP1, RASSF1, and RARB differed between the paired foci of all PCa cases. The intensity of DNA methylation in these TSGs was significantly higher in PCa cases than in BPH (p epigenetic profile of recurrent tumors can be inferred from our data.

  19. Estrutura de populações de Rhodnius neglectus Lent e Psammolestes tertius Lent & Jurberg (Hemiptera, Reduviidae em ninhos de pássaros (Furnariidae presentes na palmeira Mauritia flexuosa no Distrito Federal, Brasil Population structure of Rhodnius neglectus Lent and Psammolestes tertius Lent & Jurberg (Hemiptera, Reduviidae in bird nests (Furnariidae on Mauritia flexuosa palm trees in Federal District of Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Gurgel-Gonçalves

    2007-03-01

    Full Text Available Rhodnius neglectus Lent, 1954 {Rn}e Psammolestes tertius Lent & Jurberg, 1965 {Pt} são triatomíneos que ocorrem em ninhos de aves, principalmente da família Furnariidae. O ciclo biológico dessas espécies é conhecido em condições de laboratório, sendo poucos estudos em ecótopos silvestres. Para analisar a infestação e estrutura de populações de Rn e Pt em ninhos de aves presentes na palmeira Mauritia flexuosa Linnaeus, em duas estações climáticas do Brasil Central, foram amostradas 41 palmeiras com evidências de nidificação de Phacellodomus ruber Vieillot, 1817 (22 na estação chuvosa e 19 na estação seca em quatro áreas do Distrito Federal. Os insetos foram capturados usando-se coleta manual na copa da palmeira, identificados morfologicamente, separados por sexo e estádio ninfal. Fezes e glândulas salivares de Rn foram examinadas para verificar infecção por Trypanosoma cruzi Chagas, 1909 e/ou T. rangeli Tejera, 1920. Trinta e cinco palmeiras com ninhos de P. ruber estavam infestadas por Rn (85% e 22 por Pt (53%. 442 indivíduos foram coletados na estação seca (200 Rn e 242 Pt e 267 na estação chuvosa (136 Rn e 131 Pt. O único fator relacionado significativamente com a densidade de triatomíneos nas palmeiras foi a área. A estrutura etária das populações mostrou: a maior abundância de adultos nas populações de Pt, b maior abundância de machos em ambas as espécies e c presença de fêmeas ovipondo em ambas as estações. Nenhum dos 177 triatomíneos examinados estava infectado por T. cruzi ou T. rangeli. A estrutura etária das populações de Rn e Pt não diferiu significativamente entre as estações amostradas, indicando ausência de marcada sazonalidade para essas espécies.Rhodnius neglectus Lent, 1954 {Rn}and Psammolestes tertius Lent & Jurberg, 1965 {Pt} are triatomines that occur in bird nests, mainly furnarid nests. Their biological cycles are known in laboratory conditions and few studies were

  20. Luz y gravedad (Reflexiones geométricas sobre cáusticas y lentes gravitacionales

    Directory of Open Access Journals (Sweden)

    Elena Ortiz García

    2011-04-01

    Full Text Available Cuando los rayos de luz iluminan una taza de café en una tardesoleada, podemos observar la curva que más brilla sobre la superficie del líquido. Quizá sea ésta una oportunidad para plantearse el siguiente experimento mental: ¿cómo juegan los rayos de luz al reflejarse en diferentes “tazas” geométricas? Esta comunicación pretende proseguir esta discusión con algunas consideraciones sencillas que nos sitúen ante el fenómeno de las lentes gravitacionales, allí donde los efectos de la gravedad afectan, incluso, a la manera de propagarse de la luz, mostrando un sistema dinámico idealizado que resulta, a la vez, sencilloy (matemáticamente caótico.

  1. CURED I - LENT. Late effects of cancer treatment on normal tissues

    International Nuclear Information System (INIS)

    Rubin, P.; Okunieff, P.; Constine, L.S.; Rochester Univ. School of Medicine and Dentistry, Rochester, NY; Marks, L.B.

    2008-01-01

    The search for the most favorable therapeutic ratio - at which ablation of cancer is achieved while normal tissues are conserved - has been modern radiation oncology's equivalent of the quest for the Holy Grail. Our awareness of the late effects of radiation grew during the past century as new modalities were introduced. Heightened normal tissue reactions accompanied the higher rates of cancer ablation achieved by escalation of radiation doses, accelerated fractionated radiotherapy, and aggressive concurrent chemotherapy and radiation regimens. This volume is based on the LENT V NCI-sponsored meeting held in May 2004 and the CURED I conference held in 2006. Written by experts in the field, it addresses a number of critical topics relating to late effects, such as mechanisms of injury, the role of screening, options for interventions, second malignancies, and prevention. It is hoped that it will assist the reader in understanding how to prevent and treat the long-term side-effects of irradiation. (orig.)

  2. Medindo o poder refrativo de lentes de contato gelatinosas personalizadas Measuring the refractive power of customized soft contact lenses

    Directory of Open Access Journals (Sweden)

    Luis Alberto Vieira de Carvalho

    2007-02-01

    Full Text Available OBJETIVO: Lentes de contato gelatinosas com curvas-base esféricas têm sido usadas há anos. O cálculo do poder refrativo de lentes deste tipo é fácil, bastando utilizarmos a equação do fabricante de lentes para lentes espessas. No entanto, para projetos de lentes de contato personalizadas, não há ainda métodos confiáveis para medida das aberrações ópticas de ordem mais alta. Esse trabalho foi desenvolvido no laboratório do Centro de Ciências da Visão (Center for Visual Science da Universidade de Rochester, Nova York, com aparelho óptico que permite realizar medidas precisas de aberrações de ordem baixa e alta de lentes de contato gelatinosas personalizadas. Este é um passo essencial na verificação e obtenção de lentes de contato personalizadas de qualidade, e o instrumento desenvolvido na Universidade de Rochester permite verificar a qualidade de fabricação destas lentes. MÉTODOS: Um aparelho óptico de bancada foi montado em laboratório. Este aparelho consiste de uma célula úmida onde as lentes de contato são depositadas. Consiste também de uma série de lentes e espelhos e um sensor de frente-de-onda de Hartmann-Shack. As lentes de contato personalizadas utilizadas neste projeto foram fabricadas pela empresa Bausch & Lomb. Das dezenas de lentes de contato mensuradas no aparelho, restringimos aqui a apresentar os resultados de uma lente personalizada para ceratocone. RESULTADOS: O erro quadrático médio (EQM do instrumento foi de 0,04 micrômetro, sendo que o EQM das aberrações induzidas na lente está entre 4 e 6 micrômetros, ou seja, a precisão do aparelho está em torno de 1%. Este valor é mais do que suficiente para medidas precisas destes tipos de lentes de contato, algo até então inviável utilizando-se os sensores ou aparelhos convencionais de aberrometria. CONCLUSÃO: Com o instrumento desenvolvido neste trabalho foi possível realizar medidas precisas de aberrações de alta ordem. Esta

  3. Comparison of the visual and intraocular optical performance of a refractive multifocal IOL with rotational asymmetry and an apodized diffractive multifocal IOL.

    Science.gov (United States)

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José

    2012-02-01

    To compare the visual outcomes and intraocular optical quality observed postoperatively in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL) and an apodized diffractive multifocal IOL. Seventy-four consecutive eyes of 40 cataract patients (age range: 36 to 79 years) were divided into two groups: zonal refractive group, 39 eyes implanted with a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 IOL, Oculentis GmbH); and diffractive group, 35 eyes implanted with an apodized diffractive multifocal IOL (ReSTOR SN6AD3, Alcon Laboratories Inc). Distance and near visual acuity outcomes, contrast sensitivity, intraocular optical quality, and defocus curves were evaluated during 3-month follow-up. Calculation of the intraocular aberrations was performed by subtracting corneal aberrations from total ocular aberrations. Uncorrected near visual acuity and distance-corrected near visual acuity were better in the diffractive group than in the zonal refractive group (P=.01), whereas intermediate visual acuity (defocus +1.00 and +1.50 diopters) was better in the zonal refractive group. Photopic contrast sensitivity was significantly better in the zonal refractive group (P=.04). Wavefront aberrations (total, higher order, tilt, primary coma) were significantly higher in the zonal refractive group than in the diffractive group (P=.02). Both multifocal IOLs are able to successfully restore visual function after cataract surgery. The zonal refractive multifocal IOL provides better results in contrast sensitivity and intermediate vision, whereas the diffractive multifocal IOL provides better near vision at a closer distance. Copyright 2012, SLACK Incorporated.

  4. Conservative treatment of soft tissue sarcomas of the extremities. Functional evaluation with LENT-SOMA scales and the Enneking score

    International Nuclear Information System (INIS)

    Tawfiq, N.; Lagarde, P.; Thomas, L.; Kantor, G.; Stockle, E.; Bui, B.N.

    2000-01-01

    Objective. - The aim of this prospective study is the feasibility of late effects assessment by LENT-SOMA scales after conservative treatment of soft tissue sarcomas of the extremities and a comparison with the functional evaluation by the Enneking score. Patients and methods. - During the systematic follow-up consultations, a series of 32 consecutive patients was evaluated in terms of late effects by LENT SOMA scales and functional results by the Enneking score. The median time after treatment was 65 months. The treatment consisted of conservative surgery (all cases) followed by radiation therapy (29 cases), often combined with adjuvant therapy (12 concomitant radio-chemotherapy association cases out of 14). The assessment of the toxicity was retrospective for acute effects and prospective for the following late tissue damage: skin/subcutaneous tissues, muscles/soft tissues and peripheral nerves. Results. -According to the Enneking score, the global score for the overall series was high (24/30) despite four the scores zero for the psychological acceptance. According to LENT SOMA scales, a low rate of severe sequelae (grade 3-4) was observed. The occurrence of high-grade sequelae and their functional consequences were not correlated with quality of exeresis, dose of radiotherapy or use of concomitant chemotherapy. A complementarity was observed between certain factors of the Enneking score and some criteria of the LENTSOMA scales, especially of muscles/soft tissues. Conclusion. -The good quality of functional results was confirmed by the two mean scoring systems for late normal tissue damage. The routine use of LENT-SOMA seems to be more time consuming than the Enneking score (mean time of scoring: 1 3 versus five minutes). The LENT-SOMA scales are aimed at a detailed description of late toxicity and sequelae while the Enneking score provides a more global evaluation, including the psychological acceptance of treatment. The late effects assessment by the LENT

  5. A case of osseous scintigraphy showing focuses of multifocal tuberculosis

    International Nuclear Information System (INIS)

    Faurous-Vanaud, R.; Faurous, P.; Kalfa, G.; Collet, H.; Couty, H.; Artus, J.C.

    1997-01-01

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur's upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  6. Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Warmuth-Metz Monika

    2007-01-01

    Full Text Available Abstract Background Hypophosphatasia (HP is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism. Case presentation We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP. Conclusion Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti

  7. Acute posterior multifocal placoid pigment epitheliopathy associated with cerebral vasculitis.

    Science.gov (United States)

    Weinstein, J M; Bresnick, G H; Bell, C L; Roschmann, R A; Brooks, B R; Strother, C M

    1988-09-01

    Acute multifocal posterior placoid pigment epitheliopathy (APMPPE) is an unusual self-limited retinal disorder that has been associated with various systemic complications. To our knowledge, three prior cases associated with cerebral vasculitis have been described. This article describes a patient with APMPPE and angiographically documented cerebral vasculitis who was notable because of (a) the presence of two different cerebral ischemic events, occurring 1 month apart, and (b) the long latency (3 months) between the onset of ocular symptoms and the second cerebral ischemic event. Recognition of the association between APMPPE and cerebral vasculitis may permit early treatment of CNS involvement and prevention of morbidity.

  8. The multifaceted presentation of chronic recurrent multifocal osteomyelitis

    DEFF Research Database (Denmark)

    Girschick, Hermann; Finetti, Martina; Orlando, Francesca

    2018-01-01

    Objectives: Chronic non-bacterial osteomyelitis (CNO) or chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder characterized by sterile bone osteolytic lesions. The aim of this study was to evaluate the demographic data and clinical, instrumental and therapeutic features...... with glucocorticoids, 61 with bisphosphonates, 58 with MTX, 47 with SSZ, 26 with anti-TNF and 4 with anakinra, with a variable response. Conclusion: This is the largest reported case series of CNO patients, showing that the range of associated clinical manifestations is rather heterogeneous. The study confirms...... that the disease usually presents with an early teenage onset, but it may also occur in adults, even in the absence of mucocutaneous manifestations....

  9. A role for susceptibility weighted imaging in progressive multifocal leukoencephalopathy

    LENUS (Irish Health Repository)

    Yap, SM

    2017-04-01

    We report a radiologic finding on magnetic resonance imaging (MRI) of the brain of two cases of progressive multifocal leukoencephalopathy (PML) of hypointense signal of subcortical U-fibres on susceptibility weighted (SW) sequence. The first case is a 50-year-old man recently treated with chemotherapy including rituximab for non-Hodgkin\\'s lymphoma. The second case is a 64-year-old woman with human immunodeficiency virus (HIV) infection. Iron deposition is a likely causative factor. We propose that SWI may be especially useful in the assessment of indeterminate cases to reduce the likelihood of a missed diagnosis of PML

  10. Aggressive and multifocal pulmonary inflammatory myofiberblastic tumor in young woman

    International Nuclear Information System (INIS)

    Choi, Yang Sean; Chung, Myung Hee; Kim, Hyun Jung; Park, Ki Hoon; Kim, Jeanna; Kwon, Soon Suck; Yoo, Won Jong

    2016-01-01

    We report a case of pulmonary inflammatory myofibroblastic tumor (IMT) showing aggressive and unusually rapid progression. A 27-year-old woman was admitted to the emergency room due to dry cough, fever and blood-tinged sputum that lasted one week. Initial chest radiograph and computed tomography scan revealed multifocal pulmonary nodules, which subsequently progressed into large necrotic masses within two months. She underwent a fine needle biopsy of the largest mass in the right middle lung zone which revealed inflammatory myofibroblastic cells consistent with IMT. The masses showed complete regression after six months of corticosteroid therapy. This unusual clinical manifestation could help explain the reactive inflammatory nature associated with IMTs

  11. Aggressive and multifocal pulmonary inflammatory myofiberblastic tumor in young woman

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yang Sean; Chung, Myung Hee; Kim, Hyun Jung; Park, Ki Hoon; Kim, Jeanna; Kwon, Soon Suck; Yoo, Won Jong [Bucheon St. Mary' s Hospital, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2016-08-15

    We report a case of pulmonary inflammatory myofibroblastic tumor (IMT) showing aggressive and unusually rapid progression. A 27-year-old woman was admitted to the emergency room due to dry cough, fever and blood-tinged sputum that lasted one week. Initial chest radiograph and computed tomography scan revealed multifocal pulmonary nodules, which subsequently progressed into large necrotic masses within two months. She underwent a fine needle biopsy of the largest mass in the right middle lung zone which revealed inflammatory myofibroblastic cells consistent with IMT. The masses showed complete regression after six months of corticosteroid therapy. This unusual clinical manifestation could help explain the reactive inflammatory nature associated with IMTs.

  12. An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

    African Journals Online (AJOL)

    Multifocal choroiditis is a vision‑threatening disease causing inflammation at the level of retinal pigment epithelium and outer retina. We present a unique case of unilateral multifocal choroiditis in a young nonmyopic male and its subsequent course. The patient developed visual loss due to the sub‑retinal neovascular ...

  13. Whole body MRI in the diagnosis of chronic recurrent multifocal osteomyelitis.

    LENUS (Irish Health Repository)

    Kennedy, M T

    2012-06-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a diagnosis of exclusion primarily in children and adolescents. As part of the essential criteria for the diagnosis of CRMO, multifocal lesions must be identified. We present the case of an 11-year-old boy with CRMO, whose diagnosis was facilitated by the use of whole body magnetic resonance imaging (WBMR), but not isotope bone scanning.

  14. Three-dimensional vectorial multifocal arrays created by pseudo-period encoding

    Science.gov (United States)

    Zeng, Tingting; Chang, Chenliang; Chen, Zhaozhong; Wang, Hui-Tian; Ding, Jianping

    2018-06-01

    Multifocal arrays have been attracting considerable attention recently owing to their potential applications in parallel optical tweezers, parallel single-molecule orientation determination, parallel recording and multifocal multiphoton microscopy. However, the generation of vectorial multifocal arrays with a tailorable structure and polarization state remains a great challenge, and reports on multifocal arrays have hitherto been restricted either to scalar focal spots without polarization versatility or to regular arrays with fixed spacing. In this work, we propose a specific pseudo-period encoding technique to create three-dimensional (3D) vectorial multifocal arrays with the ability to manipulate the position, polarization state and intensity of each focal spot. We experimentally validated the flexibility of our approach in the generation of 3D vectorial multiple spots with polarization multiplicity and position tunability.

  15. Guía Clínica para la Adaptación de Lentes de Contacto Multifocales Tóricas Hidrofílicas

    OpenAIRE

    García Valencia, Lidia

    2015-01-01

    Elaboración de una guía clínica para la adaptación de lentes de contacto multifocales tóricas, basada en la bibliografía existente sobre ese tipo de lentes de contacto y un caso clínico utilizado para faciltar su comprensión. Grado en Óptica y Optometría

  16. Reorganization of Students Disability Support Unit in Bülent Ecevit University

    Directory of Open Access Journals (Sweden)

    Hakan KALYON

    2012-01-01

    Full Text Available Universities are the centers where science and knowledge can be produced and shared freely. In these centers, it is probable that disabled people can be in the audience and benefit from these training and education activities. Therefore, removing inequalities defined as “inequitable differences of individuals not caused by personal characteristics” and solving problems in accessing information and education is an indispensible target for our country.The highest step among the needs of the human beings is self-perform. Especially, in the social order of 21st century, the disabled people who aim to meet the expectations of life should be supported allover.Turkey has a young and dynamic population; there is a significant increase in the number of the disabled students who reach and graduate from higher education in 2000s. In 2000, 97 disabled students graduated from universities and this number reached 410 in 2008 and 1090 in 2009. Number of disabled students in the Universities of Turkey reached 3584 in 2011.One of the most important examples in the process of legislative changes about the education of disabled people is the “Institutions of Higher Education Disabled People Consultation and Coordination Regulation.” The purpose of the regulation is to take steps in order to ease the education lives of the disabled people in higher education. In the context of applicable law, the unit of disabled students is restructured at Bülent Ecevit University.

  17. Late effects of normal tissues (lent) scoring system: the soma scale

    International Nuclear Information System (INIS)

    Mornex, F.; Pavy, J.J.; Denekamp, J.

    1997-01-01

    Radiation tolerance of normal tissues remains the limiting factor for delivering tumoricidal dose. The late toxicity of normal tissues is the most critical element of an irradiation: somatic, functional and structural alterations occur during the actual treatment itself, but late effects manifest months to years after acute effects heal, and may progress with time. The optimal therapeutic ratio ultimately requires not only complete tumor clearance, but also minimal residual injury to surrounding vital normal tissues. The disparity between the intensity of acute and late effects and the inability to predict the eventual manifestation of late normal tissue injury has made radiation oncologists recognize the importance of careful patient follow-up. There is so far no uniform toxicity scoring system to compare several clinical studies in the absence of a 'common toxicity language'. This justifies the need to establish a precise evaluation system for the analysis of late effects of radiation on normal tissues. The SOMA/LENT scoring system results from an international collaboration. European Organization Treatment of Cancer (EORTC) and Radiation Therapy Oncology Group (RTOG) have created subcommittees with the aim of addressing the question of standardized toxic effects criteria. This effort appeared as a necessity to standardize and improve the data recording, to then describe and evaluate uniform toxicity at regular time intervals. The current proposed scale is not yet validated, and should be used cautiously. (authors)

  18. Multifocal ERG wavelet packet decomposition applied to glaucoma diagnosis

    Directory of Open Access Journals (Sweden)

    Rodríguez-Ascariz José M

    2011-05-01

    Full Text Available Abstract Background Glaucoma is the second-leading cause of blindness worldwide and early diagnosis is essential to its treatment. Current clinical methods based on multifocal electroretinography (mfERG essentially involve measurement of amplitudes and latencies and assume standard signal morphology. This paper presents a new method based on wavelet packet analysis of global-flash multifocal electroretinogram signals. Methods This study comprised twenty-five patients diagnosed with OAG and twenty-five control subjects. Their mfERG recordings data were used to develop the algorithm method based on wavelet packet analysis. By reconstructing the third wavelet packet contained in the fourth decomposition level (ADAA4 of the mfERG recording, it is possible to obtain a signal from which to extract a marker in the 60-80 ms time interval. Results The marker found comprises oscillatory potentials with a negative-slope basal line in the case of glaucomatous recordings and a positive-slope basal line in the case of normal signals. Application of the optimal threshold calculated in the validation cases showed that the technique proposed achieved a sensitivity of 0.81 and validation specificity of 0.73. Conclusions This new method based on mfERG analysis may be reliable enough to detect functional deficits that are not apparent using current automated perimetry tests. As new stimulation and analysis protocols develop, mfERG has the potential to become a useful tool in early detection of glaucoma-related functional deficits.

  19. Predictability of uncontrollable multifocal seizures - towards new treatment options

    Science.gov (United States)

    Lehnertz, Klaus; Dickten, Henning; Porz, Stephan; Helmstaedter, Christoph; Elger, Christian E.

    2016-04-01

    Drug-resistant, multifocal, non-resectable epilepsies are among the most difficult epileptic disorders to manage. An approach to control previously uncontrollable seizures in epilepsy patients would consist of identifying seizure precursors in critical brain areas combined with delivering a counteracting influence to prevent seizure generation. Predictability of seizures with acceptable levels of sensitivity and specificity, even in an ambulatory setting, has been repeatedly shown, however, in patients with a single seizure focus only. We did a study to assess feasibility of state-of-the-art, electroencephalogram-based seizure-prediction techniques in patients with uncontrollable multifocal seizures. We obtained significant predictive information about upcoming seizures in more than two thirds of patients. Unexpectedly, the emergence of seizure precursors was confined to non-affected brain areas. Our findings clearly indicate that epileptic networks, spanning lobes and hemispheres, underlie generation of seizures. Our proof-of-concept study is an important milestone towards new therapeutic strategies based on seizure-prediction techniques for clinical practice.

  20. Bilateral implantation of +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes.

    Science.gov (United States)

    Nuijts, Rudy M M A; Jonker, Soraya M R; Kaufer, Robert A; Lapid-Gortzak, Ruth; Mendicute, Javier; Martinez, Cristina Peris; Schmickler, Stefanie; Kohnen, Thomas

    2016-02-01

    To assess the clinical visual outcomes of bilateral implantation of Restor +2.5 diopter (D) multifocal intraocular lenses (IOLs) and contralateral implantation of a Restor +2.5 D multifocal IOL in the dominant eye and Restor +3.0 D multifocal IOL in the fellow eye. Multicenter study at 8 investigative sites. Prospective randomized parallel-group patient-masked 2-arm study. This study comprised adults requiring bilateral cataract extraction followed by multifocal IOL implantation. The primary endpoint was corrected intermediate visual acuity (CIVA) at 60 cm, and the secondary endpoint was corrected near visual acuity (CNVA) at 40 cm. Both endpoints were measured 3 months after implantation with a noninferiority margin of Δ = 0.1 logMAR. In total, 103 patients completed the study (53 bilateral, 50 contralateral). At 3 months, the mean CIVA at 60 cm was 0.13 logMAR and 0.10 logMAR in the bilateral group and contralateral group, respectively (difference 0.04 logMAR), achieving noninferiority. Noninferiority was not attained for CNVA at 40 cm; mean values at 3 months for bilateral and contralateral implantation were 0.26 logMAR and 0.11 logMAR, respectively (difference 0.15 logMAR). Binocular defocus curves suggested similar performance in distance vision between the 2 groups. Treatment-emergent ocular adverse events rates were similar between the groups. Bilateral implantation of the +2.5 D multifocal IOL resulted in similar distance as contralateral implantation of the +2.5 D multifocal IOL and +3.0 D multifocal IOL for intermediate vision (60 cm), while noninferiority was not achieved for near distances (40 cm). Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Precisão da retinoscopia sem lentes neutralizadoras na hipermetropia experimental de olho artificial

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    Beatriz Simões-Corrêa

    2012-10-01

    Full Text Available OBJETIVO: Avaliar a acurácia e a precisão da retinoscopia sem lentes neutralizadoras na hipermetropia experimental de olho artificial. MÉTODOS: Observação da projeção da faixa do retinoscópio em olho artificial preparado para apresentar hipermetropias de +1,00 D a +8,00 D. A movimentação da faixa é feita simultaneamente com a variação da sua largura, deslocando a luva do retinoscópio até a obtenção da neutralização do movimento. O retinoscópio foi preparado para dois modos de medida: com escala milimétrica sob a luva e com acoplamento a potenciômetro ligado a multímetro de leitura digital em ohms (Ù. Oito médicos oftalmologistas realizaram 1200 retinoscopias em cada modo de medida, num total de 2400. Calculou-se a média e o desvio padrão das observações. Para comparar os resultados em mm e em ohms (Ù calculou-se o coeficiente de variação (CV a partir dos desvios padrão das observações em cada modo. RESULTADOS: Pelos modos descritos foi possível estimar hipermetropias até +4,00 dioptrias. CONCLUSÃO: A acurácia e a reprodutibilidade experimentais foram boas na identificação de hipermetropias até +4 ,00 D.

  2. Influência da redução medicamentosa da pressão intra-ocular na medida da espessura da camada de fibras nervosas da retina de olhos hipertensos e glaucomatosos pela polarimetria de varredura a laser The influence of intraocular pressure reduction with medication on retinal nerve fiber layer thickness measurements obtained with scanning laser polarimetry in glaucomatous and hypertensive eyes

    Directory of Open Access Journals (Sweden)

    Rodrigo Rezende Gomes Avelino

    2006-10-01

    Full Text Available OBJETIVO: Avaliar o efeito da redução da pressão intra-ocular (PIO obtido com o uso de terapia medicamentosa na espessura da camada de fibras nervosas da retina medida pela polarimetria de varredura a laser (PVL em pacientes glaucomatosos ou hipertensos oculares. MÉTODOS: Trinta e sete olhos de 37 pacientes foram prospectivamente incluídos no estudo e avaliados com a PVL sem uso de medicação ocular hipotensora e num período entre 15 e 30 dias após a instituição de medicação ocular hipotensora, que resultou em redução da PIO de pelo menos 25%. Os parâmetros medidos pela PVL antes e após a redução da PIO foram comparados com o teste t de Student pareado. RESULTADOS: A PIO média dos 37 pacientes diminuiu significativamente de 26,57±4,23 mmHg para 16,54±2,92 mmHg (p0,05. CONCLUSÃO: A redução da PIO com o uso de medicação ocular hipotensora não altera a medida da espessura da camada de fibras nervosas da retina pela PVL em pacientes com glaucoma ou hipertensão ocular.PURPOSE: To evaluate changes in retinal nerve fiber layer thickness as measured by scanning laser polarimetry (SLP after the use of medication to reduce intraocular pressure (IOP in glaucomatous or ocular hypertensive patients. METHODS: The authors prospectively enrolled 37 eyes of 37 patients in whom IOP was reduced by more than 25% after the use of medication. The images were obtained before and 15 to 30 days after the introduction of medication. The SLP parameters measured before and after the use of medication were compared using paired Student's t Test. RESULTS: The mean IOP was significantly reduced from 26.57±4.23 mmHg to 16.54 ±2.92 mmHg after the use of medication (p0.05. CONCLUSION: The retinal nerve fiber layer thickness, as measured by SLP, is not affected by the reduction of IOP with medication in patients with glaucoma or ocular hypertension.

  3. MULTIFOCAL RETINAL INFILTRATES WITH PHLEBITIS AND OPTIC NEUROPATHY IN AN HIV-POSITIVE PEDIATRIC PATIENT.

    Science.gov (United States)

    Kasi, Sundeep K; Vora, Robin A; Martin, Taliva; Cunningham, Emmett T

    2015-01-01

    To describe an unusual presentation of bilateral HIV-associated multifocal retinal infiltrates with phlebitis and optic neuropathy in a pediatric patient from Zimbabwe, Africa. Retrospective case report of a 15-year-old boy from Zimbabwe, Africa. The patient was found to have bilateral vitritis, multifocal retinitis with phlebitis, and optic neuropathy in the setting of previously unrecognized HIV infection. Vision improved and the clinical findings resolved after treatment with intravenous corticosteroids and highly active retroviral therapy (HAART). The authors describe the occurrence and treatment of bilateral, HIV-associated multifocal retinal infiltrates with phlebitis and HIV-associated optic neuropathy in a pediatric patient from Zimbabwe, Africa.

  4. Multifocal epithelial hyperplasia: a forgotten condition in the elderly.

    Science.gov (United States)

    Shamloo, Nafiseh; Mortazavi, Hamed; Taghavi, Nasim; Baharvand, Maryam

    2016-01-01

    Multifocal epithelial hyperplasia (MEH), also known as focal epithelial hyperplasia and Heck disease, is a relatively rare condition caused by the human papillomavirus. This case report describes a 92-year-old man who presented with multiple, asymptomatic, circumscribed, soft, flattened papules in different sizes on the retrocommissure of his lower lip. The lesions were of 2 months' duration and had the same coloration as the adjacent normal mucosa. Histopathologic examination showed orthokeratinized stratified squamous epithelium with acanthosis, some areas of club-shaped rete ridges, and a few superficial epithelial cells with koilocytic changes and a mitosoid-like appearance. A diagnosis of MEH was established. Although MEH tends to occur in the first 2 decades of life, it can be encountered in elderly patients as well.

  5. Multifocal bone and bone marrow lesions in children - MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Raissaki, Maria; Demetriou, Stelios; Spanakis, Konstantinos; Skiadas, Christos; Karantanas, Apostolos H. [University of Crete, Faculty of Medicine, Department of Radiology, University Hospital of Heraklion, Heraklion, Crete (Greece); Katzilakis, Nikolaos; Stiakaki, Eftichia [University of Crete, Faculty of Medicine, Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Crete (Greece); Velivassakis, Emmanouil G. [University Hospital of Heraklion, Orthopedic Clinic, Heraklion, Crete (Greece)

    2017-03-15

    Polyostotic bone and bone marrow lesions in children may be due to various disorders. Radiographically, lytic lesions may become apparent after loss of more than 50% of the bone mineral content. Scintigraphy requires osteoblastic activity and is not specific. MRI may significantly contribute to the correct diagnosis and management. Accurate interpretation of MRI examinations requires understanding of the normal conversion pattern of bone marrow in childhood and of the appearances of red marrow rests and hyperplasia. Differential diagnosis is wide: Malignancies include metastases, multifocal primary sarcomas and hematological diseases. Benign entities include benign tumors and tumor-like lesions, histiocytosis, infectious and inflammatory diseases, multiple stress fractures/reactions and bone infarcts/ischemia. (orig.)

  6. Multifocal dystonia, Clinical feature of Hallervorden-Spatz

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    Ghelichkhani H

    1998-09-01

    Full Text Available Hallervorden-spatz disease is an inherited metabolic disorder with autosomal recessive trait. Onset is in late childhood or early adolescence. Clinical manifestation is variable but pyramidal and extrapyramidal signs are often prominent. Many of patients show progressive dementia and extrapyramidal symptoms. Ataxia or myoclonus is reported in the course of the disease in individual cases. Focal dystonias including tongue, eyelids (blepharospasm and optic atrophy, retinitis pigmentosa, rarely familial parkinsonism are also reported. Pathologically pigmentary degeneration of globus pallidus, substantia nigra (pars reticular and red nucleus is characteristic. In our case the main clinical feature was multifocal dystonia without obvious pyramidal or other extrapyramidal symptoms, and diagnosis was based on clinical and MRI findings.

  7. Progressive multifocal leukoencephalopathy limited to the brain stem

    Energy Technology Data Exchange (ETDEWEB)

    Kastrup, O.; Maschke, M.; Diener, H.C. [Neurologische Universitaetsklinik, University of Essen (Germany); Wanke, I. [Department of Neuroradiology, University of Essen (Germany)

    2002-03-01

    Progressive multifocal leukoencephalopathy (PML) is a subacute demyelinating slow-virus encephalitis caused by the JC polyomavirus in 2-5% of patients with AIDS. MRI typically shows multiple lesions in the cerebral hemispheres. We present a rare case of rapidly evolving and lethal PML with a severe bulbar syndrome and spastic tetraparesis in a patient with AIDS. MRI showed high-signal lesions on T2-weighted images confined to the brain stem, extending from the medulla oblongata to the midbrain. JC virus polymerase chain reaction in cerebrospinal fluid was positive, and neuropathology showed the findings of PML. This case was also notable because of the rapid progression despite improved immune status with antiretroviral therapy. (orig.)

  8. MONTE CARLO SIMULATION OF MULTIFOCAL STOCHASTIC SCANNING SYSTEM

    Directory of Open Access Journals (Sweden)

    LIXIN LIU

    2014-01-01

    Full Text Available Multifocal multiphoton microscopy (MMM has greatly improved the utilization of excitation light and imaging speed due to parallel multiphoton excitation of the samples and simultaneous detection of the signals, which allows it to perform three-dimensional fast fluorescence imaging. Stochastic scanning can provide continuous, uniform and high-speed excitation of the sample, which makes it a suitable scanning scheme for MMM. In this paper, the graphical programming language — LabVIEW is used to achieve stochastic scanning of the two-dimensional galvo scanners by using white noise signals to control the x and y mirrors independently. Moreover, the stochastic scanning process is simulated by using Monte Carlo method. Our results show that MMM can avoid oversampling or subsampling in the scanning area and meet the requirements of uniform sampling by stochastically scanning the individual units of the N × N foci array. Therefore, continuous and uniform scanning in the whole field of view is implemented.

  9. Digitally switchable multi-focal lens using freeform optics.

    Science.gov (United States)

    Wang, Xuan; Qin, Yi; Hua, Hong; Lee, Yun-Han; Wu, Shin-Tson

    2018-04-16

    Optical technologies offering electrically tunable optical power have found a broad range of applications, from head-mounted displays for virtual and augmented reality applications to microscopy. In this paper, we present a novel design and prototype of a digitally switchable multi-focal lens (MFL) that offers the capability of rapidly switching the optical power of the system among multiple foci. It consists of a freeform singlet and a customized programmable optical shutter array (POSA). Time-multiplexed multiple foci can be obtained by electrically controlling the POSA to switch the light path through different segments of the freeform singlet rapidly. While this method can be applied to a broad range of imaging and display systems, we experimentally demonstrate a proof-of-concept prototype for a multi-foci imaging system.

  10. Progressive Multifocal Leukoencephalopathy [version 1; referees: 2 approved

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    Laura Adang

    2015-12-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a devastating demyelinating disease with significant morbidity and mortality and no effective, targeted therapies. It is most often observed in association with abnormalities of cell-mediated immunity, in particular human immunodeficiency virus (HIV infection, but also occurs in association with lymphoproliferative diseases, certain immunosuppressive and immunomodulatory regimens, and other conditions. The etiologic agent of PML is a small, ubiquitous polyomavirus, the JC virus (JCV, also known as JCPyV, for which at least 50% of the adult general population is seropositive. PML results when JCV replicates within cerebral oligodendrocytes and astrocytes, leading to oligodendrocyte death and demyelination. Unfortunately, no treatments have been convincingly demonstrated to be effective, though some have been employed in desperation; treatment otherwise includes attempts to restore any immune system defect, such as the withdrawal of the causative agent if possible, and general supportive care.

  11. Bilateral Multifocal Hamartoma of the Chest Wall in an Infant

    Science.gov (United States)

    Yilmaz, Erdem; Erol, Oguz Bulent; Pekcan, Melih; Gundogdu, Gokcen; Bilgic, Bilge; Gun, Feryal; Yekeler, Ensar

    2015-01-01

    Summary Background Hamartoma of the thoracic wall is a rare benign tumor that occurs in infancy and can be mistaken for a malignancy due to its clinical and imaging features. Hamartomas are extrapleural soft tissue lesions that cause rib expansion and destruction and appear on imaging as cystic areas with fluid levels and calcification. They can cause scoliosis, pressure on the neighboring lung parenchyma and mediastinal displacement. While conservative treatment is recommended in asymptomatic cases, growing lesions require surgical excision. Case Report In this report, we present the imaging findings in a 3-month-old infant that presented with a firm swelling in the chest wall and was histopathologically confirmed to have a bilateral multifocal hamartoma. Conclusions Radiological imaging methods are important for accurate diagnosis of this very rare condition that can be confused with a malignancy. PMID:26082822

  12. Multifocal Abrikossoff's granular cell tumor of the oesophagus: Case report

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    Ranđelović Tomislav D.

    2008-01-01

    Full Text Available INTRODUCTION Granular cell tumors, relatively uncommon soft tissue tumors, have been a matter of debate among pathologists regarding histogenesis for a long time. Less common locations are in the aerodigestive tract including the oesophagus. CASE OUTLINE We have recently treated a rare case, a 37-year old male, who was admitted due to dysphagia and a painful swallow with occasional pharyngo-nasal regurgitation followed with a mild loss of weight. Standard clinical examination including X-ray chest, ECG and laboratory tests did not show pathological findings. Barium contrast oesophagography demonstrated multiple ovoid defects in the wall of the oesophagus. CT scan of the chest confirmed luminal narrowing owing to the tumor of the upper oesophagus. Upper endoscopy showed unusual multifocal nodular lesions alongside the oesophageal axis covered by smooth mucosa. A primary biopsy specimen taken from the largest nodules confirmed an unusual pathological finding of the granular cell tumor. Subtotal, transpleural oesophagectomy was performed and reconstruction was derived by long colon segment interposition through the posterior mediastinum. The postoperative course was uneventful. The operative specimen consisted of four ovoid tumors alongside the oesophagus (the greatest diameter 0.5-1.8, average 1.25. All verified tumors histologicaly consisted of a spindle-shaped or polygonal cells containing small and large eosinophilic granules and central nuclei. Most tumor cells showed strongly positive immunohistochemical staining for S-100 protein. These tumor cells were partially positive for p-53 and Ki-67. No lymph node metastases were detected histologically. CONCLUSION Multifocal granular cell tumor of the oesophagus is an unusual finding with low incidence, and rarely caused symptoms. Pathological features and multiplicity of such tumors emphasized malignant predisposition requiring surgical resection of the oesophagus.

  13. Power Profiles of Commercial Multifocal Soft Contact Lenses.

    Science.gov (United States)

    Kim, Eon; Bakaraju, Ravi C; Ehrmann, Klaus

    2017-02-01

    To evaluate the optical power profiles of commercially available soft multifocal contact lenses and compare their optical designs. The power profiles of 38 types of multifocal contact lenses-three lenses each-were measured in powers +6D, +3D, +1D, -1D, -3D, and -6D using NIMO TR1504 (Lambda-X, Belgium). All lenses were measured in phosphate buffered saline across 8 mm optic zone diameter. Refractive index of each lens material was measured using CLR 12-70 (Index Instruments, UK), which was used for converting measured power in the medium to in-air radial power profiles. Three basic types of power profiles were identified: center-near, center-distance, and concentric-zone ring-type designs. For most of the lens types, the relative plus with respect to prescription power was lower than the corresponding spectacle add. For some lens types, the measured power profiles were shifted by up to 1D across the power range relative to their labeled power. Most of the lenses were designed with noticeable amounts of spherical aberration. The sign and magnitude of spherical aberration can either be power dependent or consistent across the power range. Power profiles can vary widely between the different lens types; however, certain similarities were also observed between some of the center-near designs. For the more recently released lens types, there seems to be a trend emerging to reduce the relative plus with respect to prescription power, include negative spherical aberration, and keep the power profiles consistent across the power range.

  14. Clinical outcomes of a new diffractive multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Baha Toygar

    2017-12-01

    Full Text Available AIM: To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens (IOL with +3.00 addition power. METHODS: This is a retrospective, consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012 (Moss Vision Inc. Ltd, London, UK multifocal IOL. Patients followed for 6mo were included in the study. Data on distance, intermediate and near visual acuity, refractive error [manifest spherical equivalent (MSE], contrast sensitivity, adverse events, subjective symptoms, spectacle independence and patient satisfaction [visual function questionnaire (VFQ-25 questionnaire] were retrieved from electronic medical records and analyzed. RESULTS: Forty eyes of 20 patients with a mean age of 66.7±8.5y (range: 53-82 were included in the study. Mean uncorrected distance, near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 logMAR, Jaeger 4 and Jaeger 3 respectively at the 6mo visit. At the end of postoperative 6mo, MSE was -0.14±0.42 diopters (D and 98% of the eyes were within 1.00 D of target refraction. Postoperative low contrast (10% visual acuity remained stable (P=0.54 through follow up visits with a mean of 0.35±0.17 logMAR at the 6mo visit. There were no reported adverse events. None of the patients reported subjective symptoms of halo or glare. Spectacle independence rate was 90%. Mean VFQ-25 questionnaire score was 93.5±6.12. CONCLUSION: The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance, intermediate and near visual acuity without impairing contrast sensitivity. High levels of spectacle independence were achieved at all distances including intermediate distance.

  15. IDIOPATHIC MULTIFOCAL CHOROIDITIS PRESENTING WITH A TRANSIENT PERIPAPILLARY WHITE RING.

    Science.gov (United States)

    Gattoussi, Sarra; Ghadiali, Quraish; Dolz-Marco, Rosa; Freund, K Bailey

    2017-11-22

    We describe with multimodal imaging the presentation and follow-up for a patient with idiopathic multifocal choroiditis and a transient peripapillary white ring. Case report. A 39-year-old Asian woman was initially seen for an evaluation of lattice degeneration in 2015. Her medical history included Graves disease and psoriasis. Best-corrected visual acuity was 20/25 in her right eye and 20/25 in her left eye. Ultra-widefield fundus autofluorescence imaging showed a curvilinear hyperautofluorescent line in her right eye. One year later, the patient returned complaining of floaters in her right eye for 1 month. Her visual acuity was unchanged. Funduscopic examination showed new inflammatory yellowish lesions in the right eye corresponding to hyperreflective sub-retinal pigment epithelium lesions on structural spectral domain optical coherence tomography. Fluorescein angiography showed corresponding late staining of these active lesions. Late-phase indocyanine green angiography showed multiple nummular hypocyanescent dots. Ultra-widefield fundus autofluorescence showed large areas of hyperautofluorescence. The patient was started on a 60-mg oral prednisone taper and demonstrated subsequent regression of the inflammatory lesions. Ten months later, the patient returned emergently with complaints of floaters in both eyes for 2 days and a new temporal scotoma in her left eye. Funduscopic examination demonstrated a white ring around the optic nerve of the left eye corresponding to a hyperautofluorescent lesion. Ultra-widefield fundus autofluorescence showed new areas of hyperautofluorescence in both eyes. Structural spectral domain optical coherence tomography showed new sub-retinal pigment epithelium inflammatory lesions and a disruption of the ellipsoid zone in both eyes. The patient was again treated with a 60-mg oral prednisone taper and demonstrated subsequent restoration of the ellipsoid zone. To our knowledge, this is the first report of a transient annular white

  16. The impact of radiotherapy for carcinoma of the cervix on sexual function assessed using the LENT SOMA scales

    International Nuclear Information System (INIS)

    Davidson, Susan E.; Burns, Meriel P.; Routledge, Jacqueline A.; Swindell, Ric

    2003-01-01

    Background and purpose: As there are few studies examining the impact of radiotherapy on sexuality, we assessed the effect of radiotherapy for carcinoma of the cervix on sexual health and the ability of the LENT system to assess sexual function. Materials and methods: Using the vagina and sexual dysfunction scales of the LENT SOMA scales, subjective scores were measured prospectively before initiation of radiotherapy for 89 women, and at the following times after the start of treatment: 21, 70, 200, 400, 600 and 800 days. Results: There was considerable variation in pre-radiotherapy scores that was not related to disease stage (P=0.054), but was related to patient age (P=0.037, for the average vagina scores and P=0.039 for the maximum vagina scores) The scores were influenced by prior surgery (P<0.0005 for maximum and average vagina scores, P=0.042 average and 0.017 maximum sexual dysfunction scores). For 48 patients for whom data were available at the first three time points, the vagina scores decreased significantly by 70 days compared to pre-radiotherapy scores, but not for sexual dysfunction. There was heterogeneity in the pattern of changes of scores over time: for some women there was no change in vagina subsection score, some increased, and some decreased. Conclusions: The work has shown variation both in pre-treatment sexual function and in the pattern of changes seen following radiotherapy. Our questionnaire proved useful to score subjective sexual and vaginal problems as given in the LENT subjective scales. Further study is needed to assess the effectiveness of the scales in assessing late effects

  17. Principios para el cálculo de la lente intraocular tras cirugía refractiva corneal

    Directory of Open Access Journals (Sweden)

    Taimí Cárdenas Díaz

    Full Text Available Se estima que aproximadamente un millón o más de pacientes se realizan cirugía refractiva al año. Es por eso que con el envejecimiento son cada día más frecuentes los pacientes con catarata, a quienes previamente se les ha efectuado cirugía refractiva. El cálculo inexacto de la potencia dióptrica de la lente a implantar en la intervención de estos es también un problema de importancia creciente y con él la sorpresa refractiva. Este es mucho más complejo de lo normal, ya que existen dos fuentes de error: la incorrecta predicción de la posición efectiva de la lente por parte de la fórmula y la determinación errónea de la potencia de la córnea por parte de la queratometría. La corrección de estos dos factores permitirá realizar un cálculo correcto en estos ojos. De ahí la motivación para realizar una búsqueda actualizadas de los últimos diez años de diversos artículos publicados, con el objetivo de describir los principios para el cálculo de la lente intraocular tras cirugía refractiva corneal. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores.

  18. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

    Directory of Open Access Journals (Sweden)

    Escott S

    2013-02-01

    Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

  19. Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Vrijman, V.; El-Saady, R.; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

    2014-01-01

    PURPOSE: To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). METHODS: This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric

  20. MULTIFOCAL CHOROIDITIS IN DISSEMINATED SPOROTRICHOSIS IN PATIENTS WITH HIV/AIDS.

    Science.gov (United States)

    Biancardi, Ana L; Freitas, Dayvison F S; Valviesse, Vitor R G de A; Andrade, Hugo B; de Oliveira, Manoel M E; do Valle, Antonio C F; Zancope-Oliveira, Rosely M; Galhardo, Maria C G; Curi, Andre L L

    2017-01-01

    In this article, the authors describe multifocal choroiditis related to disseminated sporotrichosis in patients with HIV/AIDS. We conducted a retrospective observational study of three patients infected with HIV who presented with disseminated sporotrichosis characterized by cutaneous lesions, multifocal choroiditis, and other manifestations, including osteomyelitis and involvement of the bone marrow, larynx, pharynx, and nasal and oral mucosa. Five eyes of three patients with HIV/AIDS showed multifocal choroiditis related to disseminated sporotrichosis. The CD4 counts ranged from 25 to 53 mm. All patients were asymptomatic visually. The ocular disease was bilateral in two patients. The lesion size ranged from 1/3 to 2 disc diameters. None of the patients had vitritis. Of the 12 lesions, 9 were localized in the posterior pole (Zone 1) and 3 were localized in the mild periphery (Zone 2). Multifocal choroiditis due to disseminated sporotrichosis can occur in profoundly immunosuppressed patients with HIV/AIDS.

  1. Unusual multifocal granulomatous disease caused by actinomycetous bacteria in a nestling Derbyan parrot (Psittacula derbiana).

    Science.gov (United States)

    Park, F J; Jaensch, S

    2009-01-01

    A nestling Derbyan parrot (Psittacula derbiana) was presented with unusual subcutaneous swellings of the thigh regions, and poor growth. Histological examination revealed actinomycetous bacteria associated with multifocal systemic granulomas. The clinical and pathological findings of the case are presented, and some relevant aspects of actinomycetous bacterial infections in mammals and birds are discussed. Although granulomatous disease is encountered at times in avian species, the actinomycetous bacteria (Nocardia and Actinomyces spp.) have rarely been reported in association with multifocal granulomatous disease in birds.

  2. Taxonomy of multi-focal nematode image stacks by a CNN based image fusion approach.

    Science.gov (United States)

    Liu, Min; Wang, Xueping; Zhang, Hongzhong

    2018-03-01

    In the biomedical field, digital multi-focal images are very important for documentation and communication of specimen data, because the morphological information for a transparent specimen can be captured in form of a stack of high-quality images. Given biomedical image stacks containing multi-focal images, how to efficiently extract effective features from all layers to classify the image stacks is still an open question. We present to use a deep convolutional neural network (CNN) image fusion based multilinear approach for the taxonomy of multi-focal image stacks. A deep CNN based image fusion technique is used to combine relevant information of multi-focal images within a given image stack into a single image, which is more informative and complete than any single image in the given stack. Besides, multi-focal images within a stack are fused along 3 orthogonal directions, and multiple features extracted from the fused images along different directions are combined by canonical correlation analysis (CCA). Because multi-focal image stacks represent the effect of different factors - texture, shape, different instances within the same class and different classes of objects, we embed the deep CNN based image fusion method within a multilinear framework to propose an image fusion based multilinear classifier. The experimental results on nematode multi-focal image stacks demonstrated that the deep CNN image fusion based multilinear classifier can reach a higher classification rate (95.7%) than that by the previous multilinear based approach (88.7%), even we only use the texture feature instead of the combination of texture and shape features as in the previous work. The proposed deep CNN image fusion based multilinear approach shows great potential in building an automated nematode taxonomy system for nematologists. It is effective to classify multi-focal image stacks. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Multifocal peritoneal splenosis in Tc-99m-labeled heat-denatured red blood cell scintigraphy

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    Yoon, Min Ki; Hwang, Kyung Hoon; Choe, Won Sick [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2006-06-15

    A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as finding suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat- denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

  4. Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation.

    Science.gov (United States)

    Renz, Erik; Hackney, Madeleine; Hall, Courtney

    2016-01-01

    Intraocular lenses (IOLs) provide distance and near refraction and are becoming the standard for cataract surgery. Multifocal glasses increase variability of toe clearance in older adults navigating stairs and increase fall risk; however, little is known about the biomechanics of stair navigation in individuals with multifocal IOLs. This study compared clearance while ascending and descending stairs in individuals with monofocal versus multifocal IOLs. Eight participants with multifocal IOLs (4 men, 4 women; mean age = 66.5 yr, standard deviation [SD] = 6.26) and fifteen male participants with monofocal IOLs (mean age = 69.9 yr, SD = 6.9) underwent vision and mobility testing. Motion analysis recorded kinematic and custom software-calculated clearances in three-dimensional space. No significant differences were found between groups on minimum clearance or variability. Clearance differed for ascending versus descending stairs: the first step onto the stair had the greatest toe clearance during ascent, whereas the final step to the floor had the greatest heel clearance during descent. This preliminary study indicates that multifocal IOLs have similar biomechanic characteristics to monofocal IOLs. Given that step characteristics are related to fall risk, we can tentatively speculate that multifocal IOLs may carry no additional fall risk.

  5. Test-retest reliability of the multifocal photopic negative response.

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    Van Alstine, Anthony W; Viswanathan, Suresh

    2017-02-01

    To assess the test-retest reliability of the multifocal photopic negative response (mfPhNR) of normal human subjects. Multifocal electroretinograms were recorded from one eye of 61 healthy adult subjects on two separate days using a Visual Evoked Response Imaging System software version 4.3 (EDI, San Mateo, California). The visual stimulus delivered on a 75-Hz monitor consisted of seven equal-sized hexagons each subtending 12° of visual angle. The m-step exponent was 9, and the m-sequence was slowed to include at least 30 blank frames after each flash. Only the first slice of the first-order kernel was analyzed. The mfPhNR amplitude was measured at a fixed time in the trough from baseline (BT) as well as at the same fixed time in the trough from the preceding b-wave peak (PT). Additionally, we also analyzed BT normalized either to PT (BT/PT) or to the b-wave amplitude (BT/b-wave). The relative reliability of test-retest differences for each test location was estimated by the Wilcoxon matched-pair signed-rank test and intraclass correlation coefficients (ICC). Absolute test-retest reliability was estimated by Bland-Altman analysis. The test-retest amplitude differences for neither of the two measurement techniques were statistically significant as determined by Wilcoxon matched-pair signed-rank test. PT measurements showed greater ICC values than BT amplitude measurements for all test locations. For each measurement technique, the ICC value of the macular response was greater than that of the surrounding locations. The mean test-retest difference was close to zero for both techniques at each of the test locations, and while the coefficient of reliability (COR-1.96 times the standard deviation of the test-retest difference) was comparable for the two techniques at each test location when expressed in nanovolts, the %COR (COR normalized to the mean test and retest amplitudes) was superior for PT than BT measurements. The ICC and COR were comparable for the BT/PT and

  6. Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review)

    Science.gov (United States)

    BASCONES-MARTÍNEZ, A.; COK, S.; BASCONES-ILUNDÁIN, C.; ARIAS-HERRERA, S.; GOMEZ-FONT, R.; BASCONES-ILUNDÁIN, J.

    2012-01-01

    Multifocal epithelial hyperplasia (MEH), also known as Heck’s disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported. PMID:22740890

  7. Chronic Recurrent Multifocal Osteomyelitis Causing an Acute Scoliosis

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    Alexander Armstrong

    2013-01-01

    Full Text Available Study Design. A Case Report. Objective. We present a 15-year-old girl with an acute atypical scoliosis secondary to chronic recurrent multifocal osteomyelitis (CRMO. Summary of Background Data. CRMO is a rare nonpyogenic inflammatory bone condition with unclear aetiology. CRMO mainly affects the metaphyses of long bones, the pelvis, shoulder girdle, and less commonly the spine. Methods. Our case presented with a 6-month history of worsening thoracic back pain, asymmetry of her shoulders and abnormal posture. Whole spine radiographs revealed a right atypical thoracic scoliosis. Magnetic Resonance Imaging showed abnormal signal on the short TI inversion recovery (STIR sequences in multiple vertebrae. A bone biopsy demonstrated evidence of fibrosis and chronic inflammatory changes. Interval MRI scans revealed new oedematous lesions and disappearance of old lesions. Symptoms improved. Results. It is important to consider CRMO as an acute cause of atypical scoliosis. Malignancy, pyogenic infections and atypical presentations of juvenile arthritis need excluding. Conclusion. This 24-month follow-up describes a rare cause of an atypical scoliosis and fortifies the small amount of the currently available literature. The case highlights the relapsing and remitting nature of CRMO with new lesions developing and older lesions burning out. We advise close radiological surveillance and symptomatic management.

  8. Clinical, therapeutic, and pathogenic aspects of chronic oral multifocal candidiasis.

    Science.gov (United States)

    Holmstrup, P; Bessermann, M

    1983-10-01

    In 32 patients (11 females, 21 males) the diagnosis of chronic oral multifocal candidiasis was established on the basis of erythematous, plaquelike, or nodular lesions in two or more of the following locations: commissural area, palate, or dorsum of the tongue. Hyphae and/or pseudohyphae of Candida-like organisms were demonstrated in PAS-stained smears from all lesions. Ninety-seven separate lesions were registered. Thirty patients experienced pain, burning, or itching from affected areas. All of the patients were tobacco smokers, and 21 were denture wearers. The patients were treated with antimycotics; the median length of treatment was 46 days for denture wearers and 44 days for nondenture wearers. After antimycotic therapy the change in the lesions followed certain patterns which were determined by the original type of lesion. Palatal lesions in nondenture wearers and nodular lesions of the commissural areas showed the highest recurrence rate after 6 and 12 months. The pathogenic role of tobacco and other factors in the development of candidal infection are discussed.

  9. Progressive multifocal leukoencephalopathy. Epidemiology, clinical pictures, diagnosis and therapy

    International Nuclear Information System (INIS)

    Kishida, Shuji

    2007-01-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the reactivation of a ubiquitous polyomavirus JC (JCV). PML was for many years a rare disease occurring only in patients with underlying severe impaired immunity. Over the past three decades, the incidence of PML has significantly increased related to the AIDS (acquired immunodeficiency syndrome) pandemic and, more recently, to the growing use of immunosuppressive drugs. The clinical presentation of PML is variable with neurological symptoms corresponding to affected cerebral areas. Usually, the clinical outcome of patients with PML is poor with an inexorable progression to death within 6 months of symptom onset. Although PML usually requires a brain biopsy or autopsy for confirmation, radiological imaging and a demonstration of JCV-DNA in the CSF (cerebrospinal fluid) provide supportive evidence for the diagnosis. Although there is no proven effective therapy for PML, patients with HIV (human immunodeficeincy virus)-related PML may benefit significantly from HAART (highly active antiretroviral therapy). In this article the author reviews the epidemiology, especially in Japan, current challenges in the diagnosis and the treatment guidelines of patients with PML based on recent advances in the understanding of the JC virus biology. (author)

  10. Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

    Science.gov (United States)

    Kinoshita, Yuichi; Harada, Hiroshi; Kobayashi, Tadao K.; Yoshizawa, Katsuhiko; Yuri, Takashi; Takasu, Kosho; Tsubura, Airo; Shikata, Nobuaki

    2014-01-01

    Multifocal adenomatous oncocytic hyperplasia (MAOH) is a non-neoplastic lesion that is classified as oncocytosis. MAOH is a rare entity of the parotid gland and accounts for approximately 0.1% of salivary gland lesions. Here, we report a case of MAOH of the parotid gland. The patient was a 71-year-old woman who presented with discomfort at the left side of her neck. Fine-needle aspiration cytology of the parotid gland revealed a loose sheet-like cluster of round to polygonal cells with granular cytoplasm against a hemorrhagic background. The cells had round to oval, centrally located nuclei with granular chromatin and without distinct nucleoli. Histologically, the lesion was formed of many variable-sized nodules, comprising oncocyte-like cells with small round nuclei and eosinophilic granular cytoplasm that was positive for mitochondrial antibodies. The diagnosis of MAOH is difficult to make by cytology alone, because the findings overlap with those of other oncocytic lesions. In particular, the cytological findings of MAOH have not been sufficiently reported to date. A correlation of cytology and histology was expected. PMID:25580104

  11. Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

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    Yuichi Kinoshita

    2014-12-01

    Full Text Available Multifocal adenomatous oncocytic hyperplasia (MAOH is a non-neoplastic lesion that is classified as oncocytosis. MAOH is a rare entity of the parotid gland and accounts for approximately 0.1% of salivary gland lesions. Here, we report a case of MAOH of the parotid gland. The patient was a 71-year-old woman who presented with discomfort at the left side of her neck. Fine-needle aspiration cytology of the parotid gland revealed a loose sheet-like cluster of round to polygonal cells with granular cytoplasm against a hemorrhagic background. The cells had round to oval, centrally located nuclei with granular chromatin and without distinct nucleoli. Histologically, the lesion was formed of many variable-sized nodules, comprising oncocyte-like cells with small round nuclei and eosinophilic granular cytoplasm that was positive for mitochondrial antibodies. The diagnosis of MAOH is difficult to make by cytology alone, because the findings overlap with those of other oncocytic lesions. In particular, the cytological findings of MAOH have not been sufficiently reported to date. A correlation of cytology and histology was expected.

  12. Multifocal Electroretinography after High Dose Chloroquine Therapy for Malaria

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    Aline Correa de Carvalho

    2013-01-01

    Full Text Available Purpose: To investigate changes in multifocal electroretinography (mfERG parameters associated with high dose chloroquine therapy for treatment of malaria in the Amazonia region of Brazil. Methods: Forty-eight subjects who had received chloroquine treatment for single or multiple malaria infections with a cumulative dose ranging from 1,050 to 27,000mg were included. The control group consisted of 37 healthy aged-matched subjects. Data was collected on amplitude and implicit time of the N1, P1 and N2 waves in the central macular hexagon (R1 and in five concentric rings at different retinal eccentricities (R2-R6. Results: No significant difference was observed in any mfERG parameter between chloroquine treated patients and control subjects. A comparison with previous data obtained from patients with rheumatologic disorders in the same region of Brazil who had received larger cumulative doses of chloroquine and had displayed mfERG changes, indicated that retinal toxicity seems to be dependent on cumulative dose. Conclusion: Lack of mfERG changes in the current study suggests that intensive high dose chloroquine therapy for treatment of malaria is not associated with retinal toxicity.

  13. The effects of fundus photography on the multifocal electroretinogram.

    Science.gov (United States)

    Suresh, Sandip; Tienor, Brian J; Smith, Scott D; Lee, Michael S

    2016-02-01

    To determine the effect of flash fundus photography (FFP) on the multifocal electroretinogram (mfERG). Ten subjects underwent mfERG testing on three separate dates. Subjects received either mfERG without FFP, mfERG at 5 and 15 min after FFP, or mfERG at 30 and 45 min after FFP on each date. The FFP groups received 10 fundus photographs followed by mfERG testing, first of the right eye then of the left eye 10 min later. Data were averaged and analyzed in six concentric rings at each time point. Average amplitude and implicit times of the N1, P1, and N2 peaks for each concentric ring at each time point after FFP were compared to baseline. Flash fundus photography did not lead to a significant change of amplitude or implicit times of N1, P1, or N2 at 5 min after light exposure. These findings suggest that it is acceptable to perform mfERG testing without delay after performance of FFP.

  14. Chronic multifocal osteomyelitis: Is infectious causation a moot point?

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    Nevio Cimolai

    2011-09-01

    Full Text Available Summary: Chronic multifocal osteomyelitis (CMO is an uncommon disease entity with descriptions possibly emanating from the medical literature over one century ago, and there are numerous disease entities which have been historically detailed and which are probably synonymous. The illness is one of chronicity with exacerbating and remitting focal bony lesions. The differential diagnosis for a bony lesion which ultimately proves to be CMO is initially quite broad. There is no absolute pathognomonic clinical finding, and the diagnosis is highly dependent on clinical course, histopathology, and an absence of microbial infection. Recent studies have focused on immune dysfunction or dysregulation, and there are now many other diseases which are inflammatory in nature and which have been diagnosed among patients with CMO. Despite the aforementioned, the potential for direct infectious causation or indirect causation by infectious stimulation of immunity cannot be entirely excluded. Infection as a mechanism for pathogenesis must continue to be entertained. Multi-centre studies are key to future research. Key words: Osteomyelitis, Infection, SAPHO, Immunity

  15. Multifocal atherosclerosis in patient after acute first degree radiation sickness.

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    Metlyaeva N.A.

    2014-12-01

    Full Text Available Purpose: assessment the heavy psychosomatic and all-somatic cardiovascular and cerebrovascular pathology of patient, transferred an acute I degree radiation sickness, from the general evenly gamma-beta radiation. Conclusions. The subdepressive and disturbing-depressive syndrome of patient, transferred an acute radiation sickness (ARS of I degree, from the general evenly gamma-beta radiation, was independent risk factor of development of multifocal atherosclerosis; Features of development of all-somatic and psychosomatic pathology of patient are based on a combination of genetic prerequisites, environment influences (the stress caused by accident on the ChNPP and social factors, influencing on him during a course of life, especially during early socialization. Thus at development of psychosomatic frustration the combination of feature of the mental reaction connected with the personal characteristic and special relationship between mental (stress and physiological (somatic by aspects of reaction which led to metabolism violation, to aging, decrease in adaptation opportunities of an organism and development age — dependent pathology took place.

  16. Comparison of a new refractive multifocal intraocular lens with an inferior segmental near add and a diffractive multifocal intraocular lens.

    Science.gov (United States)

    Alio, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Moreno, Luis J; Piñero, David P

    2012-03-01

    To compare the visual acuity outcomes and ocular optical performance of eyes implanted with a multifocal refractive intraocular lens (IOL) with an inferior segmental near add or a diffractive multifocal IOL. Prospective, comparative, nonrandomized, consecutive case series. Eighty-three consecutive eyes of 45 patients (age range, 36-82 years) with cataract were divided into 2 groups: group A, 45 eyes implanted with Lentis Mplus LS-312 (Oculentis GmbH, Berlin, Germany); group B, 38 eyes implanted with diffractive IOL Acri.Lisa 366D (Zeiss, Oberkochen, Germany). All patients underwent phacoemulsification followed by IOL implantation in the capsular bag. Distance corrected, intermediate, and near with the distance correction visual acuity outcomes and contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively during a 3-month follow-up. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected distance near and intermediate visual acuity (CDNVA), contrast sensitivity, intraocular aberrations, and defocus curve. A significant improvement in UDVA, CDVA, and UNVA was observed in both groups after surgery (P ≤ 0.04). Significantly better values of UNVA (P<0.01) and CDNVA (P<0.04) were found in group B. In the defocus curve, significantly better visual acuities were present in eyes in group A for intermediate vision levels of defocus (P ≤ 0.04). Significantly higher amounts of postoperative intraocular primary coma and spherical aberrations were found in group A (P<0.01). In addition, significantly better values were observed in photopic contrast sensitivity for high spatial frequencies in group A (P ≤ 0.04). The Lentis Mplus LS-312 and Acri.Lisa 366D IOLs are able to successfully restore visual function after cataract surgery. The Lentis Mplus LS-312 provided better intermediate vision and contrast sensitivity outcomes than the Acri.Lisa 366D. However, the

  17. Resultados topográficos en pacientes portadores de lentes de contacto Topographic results achieved patients wearing contact lens

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    Tania Aymeé Díaz Martínez

    2009-06-01

    Full Text Available OBJETIVOS: Analizar los resultados topográficos en pacientes portadores de lentes de contacto y candidatos a cirugía refractiva con excimer láser, en el Hospital "Carlos Juan Finlay"; determinar el comportamiento según edad y sexo; conocer el tipo de lente de contacto empleado y su tiempo de uso; conocer el comportamiento según la edad y el sexo; identificar la relación del patrón topográfico corneal inducido en portadores de lentes de contacto con el moldeamiento corneal y el queratocono. MÉTODOS: Es un estudio retrospectivo de las topografías de los candidatos para cirugía refractiva durante los últimos 2 años, de 80 pacientes (todos ellos portadores de lentes de contacto. Para las exploraciones se emplearon los topógrafos OPTIKON AMF510P y el HUMPHREY. A todos se les realizó un examen oftalmológico completo (refracción manifiesta, biomicroscopia, queratometría, paquimetría y topografía corneal. Se compararon los resultados y su estabilidad. También se analizó la edad, el sexo, el tipo de lentes de contacto, así como su tiempo de utilización. RESULTADOS: Se trataron 158 ojos, de ellos 83 presentaron un patrón topográfico normal, 58 moldeamiento corneal inducido por el uso de lentes de contacto y en 17 se evidenció queratocono. La edad media de los pacientes fue de 27 años. El astigmatismo corneal medio en los pacientes con queratocono fue de -3,25 dioptrías, y de -1,12 dioptrías en pacientes con moldeamiento corneal. La lectura del meridiano más plano en pacientes con queratocono fue de 46,75 dioptrías, y en moldeamiento corneal 43,25 dioptrías. En los queratoconos el meridiano más curvo fue de 54,75 dioptrías, y en el moldeamiento corneal 46,00 dioptrías. CONCLUSIONES: El tipo de lente de contacto, así como su tiempo de uso influyen en la aparición del moldeamiento corneal inducido y el queratocono subclínico, y ambos presentaron un patrón topográfico similar.OBJECTIVES: To analyze the topographic

  18. Lente de contato em crianças: aspectos epidemiológicos Contact lens in children: epidemiological aspects

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    André Luiz Alves Salame

    2008-06-01

    Full Text Available OBJETIVO: Traçar o perfil epidemiológico de crianças encaminhadas para adaptação de lente de contato. MÉTODOS: Foi realizado estudo retrospectivo de pacientes registrados no Setor de lente de contato da Universidade Federal de São Paulo. Os pacientes com até 12 anos de idade foram avaliados quanto ao sexo, idade, diagnóstico, indicação e tipo de lente de contato testada na primeira consulta. RESULTADOS: Dos 73 prontuários avaliados, 34 (46,6% pertenciam a crianças do sexo masculino e 39 (53,4% a crianças do sexo feminino. A idade variou de 2 a 12 com média de 10,2 e desvio-padrão de 2,42 anos. O diagnóstico mais encontrado foi afacia em 16 (21,9% crianças, seguido de ceratocone em 14 (19,1%, leucoma em 11 (15%, anisometropia em 10 (13,7%, ametropia em 9 (12,3%, astigmatismo irregular em 7 (9,5% e ectopia lentis em 4 (5,4%. Uma criança era alta míope (1,3% e outra emétrope (1,3% que possuía desejo de usar lente de contato estética. Em relação às indicações, 52 (71,2% pacientes tinham indicação médica, 9 (12,3% indicação óptica e 12 (16,4% indicação cosmética. Foram testadas lentes em 103 olhos sendo as mais testadas a rígida gás permeável esférica em 43 (41,7%, a gelatinosa esférica em 41 (39,8% e a gelatinosa cosmética em 11 (10,6%. CONCLUSÃO: O perfil epidemiológico dos usuários de lente de contato nessa faixa etária tem como diagnóstico mais prevalente a afacia, a indicação mais freqüente a de ordem médica e a lente mais testada a rígida gás permeável esférica.PURPOSE: To describe the epidemiology of children submitted to contact lens fit. METHODS: Retrospective study of 73 children that had been submitted to contact lens fit at the "Universidade Federal de São Paulo". This study analyzed sex distribution, age, diagnosis, indications and contact lens fitted at first examination. RESULTS: 34 children (46.6% were male and 39 (53.4% female, aged between 2 and 12 years with mean of 10.2 and

  19. Resultados de implante de lente intraocular en niños Results of intraocular lens implantation in children

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    Nashelly I. Mejía Cruz

    2007-12-01

    Full Text Available En este estudio se describen los resultados obtenidos del implante de lente intraocular en niños, quienes acudieron al servicio de Oftalmología Pediátrica de Instituto Cubano de oftalmología “Ramón Pando Ferrer” con el diagnóstico de catarata de diversas etiologías, en período comprendido entre abril del 2002 al 2005 cuyo seguimiento fue durante un año. En nuestro universo de estudio se determinan algunos parámetros como la edad del paciente, etiología de las cataratas, agudeza visual, defecto refractivo preoperatorio y posoperatorio. Se identificó el poder dióptrico del lente intraocular más frecuente, la presencia de complicaciones durante la cirugía y después de esta. Se evaluaron finalmente, los pacientes que requerían de tratamiento adicional como la capsulotomía con láser o membranectomía quirúrgica. El implante del lente intraocular a temprana edad se relacionó con buenos resultados quirúrgicos: mejoría de la agudeza visual corregida, presentándose el astigmatismo como el error refractivo más frecuente. La complicación transoperatorio y postoperatoria más frecuente fue la membrana inflamatoria, mientras que la complicación posoperatoria más frecuente fue la opacidad de la cápsula posterior.This paper described the results of the intraocular lens implantation performed in children, who had been seen at the Pediatric Ophthalmologic Service of " Ramon Pando Ferrer " Cuban Institute of Ophthalmology and had been diagnosed as having cataract of various etiologies, from April 2002 to April 2005. They were all followed-up for a year. Some parameters like the patient’s age, the etiology of cataract, visual acuity, pre-operative and post-operative refractive defect were considered in our study. The dioptric power of the most common intraocular lens and the most frequent complications during and after surgery were identified. The patients requiring additional treatment such as laser capsulotomy and surgical

  20. Comparison of outcomes with multifocal intraocular lenses: a meta-analysis

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    Béatrice Cochener

    2011-01-01

    Full Text Available Béatrice Cochener1, Antoine Lafuma2, Babak Khoshnood2, Laurène Courouve2, Gilles Berdeaux3,41Centre Hospitalier Universitaire Brest, Brest, France; 2Cemka Eval, Bourg la Reine, France; 3Alcon France, Rueil-Malmaison, France; 4Conservatoire National des Arts et Métiers, Paris, FrancePurpose: To compare the clinical outcome of different multifocal intraocular lenses (IOLs based on information reported in the international literature.Methods: All comparative clinical trials that involved implanting at least one multifocal IOL in patients with cataract or presbyopia were extracted from the literature. Clinical outcomes included uncorrected near visual acuity, uncorrected distance visual acuity, visual acuity, spectacle independence, and halos. Random effects meta-analyses were conducted to compare outcomes for the different IOL types.Results: Twenty papers were identified describing 11 monofocal IOLs and 35 multifocal IOLs (19 diffractive, including 12 ReSTOR®, 14 refractive, and two accommodative patient cohorts. Multifocal and monofocal uncorrected distance visual acuity was 0.165 (0.090–0.240 and 0.093 (0.088–0.098, respectively. Compared with monofocal IOLs, multifocal IOLs produced better uncorrected near visual acuity (0.470 [0.322–0.618] versus 0.141 [0.131–0.152]; P < 0.0001, resulting in higher spectacle independence (incidence rate ratio [IRR] 3.62 [2.90–4.52]; P < 0.0001. Compared with refractive multifocal IOLs, diffractive multifocal IOLs produced a similar uncorrected distance visual acuity (0.105 [0.098–0.111] versus 0.085 [0.029–0.140]; P ≤ 0.78, not significant and better uncorrected near visual acuity (0.217 [0.118–0.317] versus 0.082 [0.067–0.098]; P < 0.0001 resulting in higher spectacle independence (IRR 1.75 [1.24–2.48]; P < 0.001. Compared with other multifocal IOLs, ReSTOR produced a better uncorrected distance visual acuity (0.067 [0.059–0.076] versus 0.093 [0.088–0.098]; P < 0.0001 and better

  1. Application of diffractive aspheric multifocal intraocular lens in the Uighur in phacoemulsification

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    Nuersimanguli·Mijiti

    2016-05-01

    Full Text Available AIM:To research the efficacy and safety of diffractive aspheric multifocal intraocular lens(MIOLin the Uighur in phacoemulsification to provide guidance for the clinical treatment of cataracts patients in Xinjiang region. METHODS:Two hundred and twenty-eight Uygur patients(280 eyesreceived phacoemulsification from April 2012 to March 2013 were randomly divided into multifocal group(106 cases with 146 eyesand monofocal group(122 cases with 134 eyes. Patients were followed up for 3mo. The intraocular pressure(IOP, uncorrected distance visual acuity, uncorrected near vision, best-corrected distance visual acuity and best corrected near vision were measured. The delensed rate, visual quality, and satisfaction for lenses in the form of questionnaires were compared. RESULTS:Multifocal group was better on the uncorrected near vision than monofocal group(PP>0.05. The contrast sensitivity of multifocal group under scotopia at spatial frequency 3c/d was lower than that of monofocal group(PP>0.05. Delensed rate of multifocal group was higher than that of monofocal group(PP>0.05.CONCLUSION:MIOL with phacoemulsification can provide patient good full range vision, especially on good near vision. The patients with MIOL implanted have a higher delensed rate, less postoperative adverse symptoms, quicker recovery and satisfaction.

  2. A multifocal collimator with circularly distributed focal points for SPECT imaging

    International Nuclear Information System (INIS)

    Guillemaud, R.; Grangeat, P.

    1994-01-01

    The authors propose a new circular multifocal collimator which has multiple axial focal points distributed on a transverse circle. This distribution provides a strong focusing at the center of the detector like a cone-beam collimator, with a good sensitivity, and a weak transverse focusing at the periphery, to ensure acquisition of sufficient data, in order to prevent truncation artifacts. For a circular acquisition trajectory, each projection set of the multifocal geometry is equivalent to a virtual cone-beam projection set with a larger detector. Due to this equivalence, the authors derive a first solution for an analytical multifocal reconstruction algorithm: to rebin the projection set from multifocal to cone-beam geometry, then to use a 3D cone-beam reconstruction algorithm. The authors propose to use the Grangeat algorithm in order to deal with a large cone-beam aperture. Finally, the authors present results on simulated data for heart phantom, for a Defrise phantom and for a MTF study. The conclusion is that, from a multifocal projection set, objects are reconstructed without truncation artifacts, with a good precision at their center and with a loss of resolution at the periphery. In addition, the 3D cone-beam artifacts are reduced with the use of the Grangeat algorithm for the reconstruction step

  3. Reading ability with pseudophakic monovision and with refractive multifocal intraocular lenses: comparative study.

    Science.gov (United States)

    Ito, Misae; Shimizu, Kimiya

    2009-09-01

    To the compare the reading ability after bilateral cataract surgery in patients who had pseudophakic monovision achieved by monofocal intraocular lens (IOL) implantation and patients who had refractive multifocal IOL implantation. Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan. This study evaluated patients who had bilateral cataract surgery using the monovision method with monofocal IOL implantation to correct presbyopia (monovision group) or who had bilateral cataract surgery with refractive multifocal IOL implantation (multifocal group). In the monovision group, the dominant eye was corrected for distance vision and the nondominant eye for near vision. The maximum reading speed, critical character size, and reading acuity were measured binocularly without refractive correction using MNREAD-J acuity charts. The monovision group comprised 38 patients and the multifocal group, 22 patients. The mean maximum reading speed was 350.5 characters per minute (cpm) +/- 62.3 (SD) in the monovision group and 355.0 +/- 53.3 cpm in the multifocal group; the difference was not statistically significant. The mean critical character size was 0.24 +/- 0.12 logMAR and 0.40 +/- 0.16 logMAR, respectively (P<.05). The mean reading acuity was 0.05 +/- 0.12 logMAR and 0.19 +/- 0.11 logMAR, respectively (P<.01). The monovision group had better critical character size and reading acuity results. The monovision method group had better reading ability; however, careful patient selection is essential.

  4. Sensitivity of imaging for multifocal-multicentric breast carcinoma

    Directory of Open Access Journals (Sweden)

    Viale Giuseppe

    2008-09-01

    Full Text Available Abstract Background This retrospective study aims to determine: 1 the sensitivity of preoperative mammography (Mx and ultrasound (US, and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC, defined by pathology on surgical specimens, and 2 to analyze the characteristics of both detected and undetected foci on Mx and US. Methods Three experienced breast radiologists re-reviewed, independently, digital mammography of 97 women with MMBC pathologically diagnosed on surgical specimens. The radiologists were informed of all neoplastic foci, and blinded to the original mammograms and US reports. With regards to Mx, they considered the breast density, number of foci, the Mx characteristics of the lesions and their BI-RADS classification. For US, they considered size of the lesions, BI-RADS classification and US pattern and lesion characteristics. According to the histological size, the lesions were classified as: index cancer, 2nd lesion, 3rd lesion, and 4th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity was calculated for Mx, US and re-reviewed Mx for detecting the presence of the index cancer as well as additional satellite lesions. Results Pathological examination revealed 13 multifocal and 84 multicentric cancers with a total of 303 malignant foci (282 invasive and 21 non invasive. Original Mx and US reports had an overall sensitivity of 45.5% and 52.9%, respectively. Mx detected 83/97 index cancers with a sensitivity of 85.6%. The number of lesions undetected by original Mx was 165/303. The Mx pattern of breasts with undetected lesions were: fatty in 3 (1.8%; scattered fibroglandular density in 40 (24.3%, heterogeneously dense in 91 (55.1% and dense in 31 (18.8% cases. In breasts with an almost entirely fatty pattern, Mx sensitivity was 100%, while in fibroglandular or dense pattern it was reduced to 45

  5. Sistemas atuais de cuidados e manutenção de lentes de contato Current care and maintenance systems for contact lenses

    Directory of Open Access Journals (Sweden)

    César Lipener

    2008-12-01

    Full Text Available A correta manutenção das lentes de contato é fundamental para se obter sucesso e manter a continuidade de seu uso. É grande o número de pacientes que abandonam o uso de suas lentes por problemas que poderiam ser solucionados com tratamentos relativamente simples ou com uma orientação mais adequada. O mau uso das lentes, associado à má adaptação, contaminação, doenças oculares prévias e fatores ambientais, podem aumentar o número de infecções corneanas através da proliferação de microorganismos. O presente artigo visa apresentar as atualizações em relação aos cuidados e manutenção com as lentes de contato.The proper maintenance of contact lenses is crucial for their success and to maintain the continuity of their use. Many patients abandon the use of their lenses due to problems that could be solved with relatively simple treatments. The misuse of lenses, coupled with poor adjustment, contamination, eye disease and environmental factors may increase the number of corneal infections through the proliferation of microorganisms. This article aims to provide contact lens care and maintenance updates.

  6. Combining zonal refractive and diffractive aspheric multifocal intraocular lenses.

    Science.gov (United States)

    Muñoz, Gonzalo; Albarrán-Diego, César; Javaloy, Jaime; Sakla, Hani F; Cerviño, Alejandro

    2012-03-01

    To assess visual performance with the combination of a zonal refractive aspheric multifocal intraocular lens (MIOL) (Lentis Mplus, Oculentis GmbH) and a diffractive aspheric MIOL (Acri.Lisa 366, Acri.Tech GmbH). This prospective interventional cohort study comprised 80 eyes from 40 cataract patients (mean age: 65.5±7.3 years) who underwent implantation of the Lentis Mplus MIOL in one eye and Acri.Lisa 366 MIOL in the fellow eye. The main outcome measures were refraction; monocular and binocular uncorrected and corrected distance, intermediate, and near visual acuities; monocular and binocular defocus curves; binocular photopic contrast sensitivity function compared to a monofocal intraocular lens (IOL) control group (40 age-matched pseudophakic patients implanted with the AR-40e [Abbott Medical Optics]); and quality of vision questionnaire. Binocular uncorrected visual acuities were 0.12 logMAR (0.76 decimal) or better at all distances measured between 6 m and 33 cm. The Lentis Mplus provided statistically significant better vision than the Acri.Lisa at distances between 2 m and 40 cm, and the Acri.Lisa provided statistically significant better vision than the Lentis Mplus at 33 cm. Binocular defocus curve showed little drop-off at intermediate distances. Photopic contrast sensitivity function for distance and near were similar to the monofocal IOL control group except for higher frequencies. Moderate glare (15%), night vision problems (12.5%), and halos (10%) were reported. Complete independence of spectacles was achieved by 92.5% of patients. The combination of zonal refractive aspheric and diffractive aspheric MIOLs resulted in excellent uncorrected binocular distance, intermediate, and near vision, with low incidence of significant photic phenomena and high patient satisfaction. Copyright 2012, SLACK Incorporated.

  7. Principal components′ analysis of multifocal electroretinogram in retinitis pigmentosa

    Directory of Open Access Journals (Sweden)

    Aniruddha Maiti

    2011-01-01

    Full Text Available Aims : To determine waveforms of multifocal electroretinogram (mfERG in patients with retinitis pigmentosa (RP contributing significantly to the overall retinal response by using principal components′ analysis. Settings and Design: Prospective, non-randomized, single-visit, observational, case-control study from a single tertiary ophthalmic center. Materials and Methods: Patients with various forms of RP underwent mfERG testing for a period of one year. The first-order kernel responses of RP cases were compared with concurrently recruited healthy controls. Statistical Analysis Used: Parametric data was analyzed using the unpaired t test for differences between the implicit time and amplitudes of cases and controls. Principal components′ analysis was done for each implicit time and amplitude in cases with RP using the Varimax rotation method. Results: From March 2006 to March 2007, 24 cases with typical RP (56%, 47 eyes were included in the final analysis. Their mean age was 33.7 years (19-69 ± 15.5 years. Comparison of latencies and amplitudes among RP cases with log MAR acuity ≤ 0.18 and those > 0.18, revealed significant difference in the implicit time (P1 in Ring 2 only (P=0.028. Two components (predominently from Ring 1 and 2 each contributing 66.8% and 88.8% of the total variance in the data for latencies and amplitudes respectively, were seen. Conclusions : The first two rings of the mfERG contributed to the variance of waveforms in RP, irrespective of the visual acuity and poor visual field results.

  8. Refractive lens exchange with a multifocal diffractive aspheric intraocular lens

    Directory of Open Access Journals (Sweden)

    Teresa Ferrer-Blasco

    2012-06-01

    Full Text Available PURPOSE: To evaluate the safety, efficacy and predictability after refractive lens exchange with multifocal diffractive aspheric intraocular lens implantation. METHODS: Sixty eyes of 30 patients underwent bilateral implantation with AcrySof® ReSTOR® SN6AD3 intraocular lens with +4.00 D near addition. Patients were divided into myopic and hyperopic groups. Monocular best corrected visual acuity at distance and near and monocular uncorrected visual acuity at distance and near were measured before and 6 months postoperatively. RESULTS: After surgery, uncorrected visual acuity was 0.08 ± 0.15 and 0.11 ± 0.14 logMAR for the myopic and hyperopic groups, respectively (50% and 46.67% of patients had an uncorrected visual acuity of 20/20 or better in the myopic and hyperopic groups, respectively. The safety and efficacy indexes were 1.05 and 0.88 for the myopic and 1.01 and 0.86 for the hyperopic groups at distance vision. Within the myopic group, 20 eyes remained unchanged after the surgery, and 3 gained >2 lines of best corrected visual acuity. For the hyperopic group, 2 eyes lost 2 lines of best corrected visual acuity, 21 did not change, and 3 eyes gained 2 lines. At near vision, the safety and efficacy indexes were 1.23 and 1.17 for the myopic and 1.16 and 1.13 for the hyperopic groups. Best corrected near visual acuity improved after surgery in both groups (from 0.10 logMAR to 0.01 logMAR in the myopic group, and from 0.10 logMAR to 0.04 logMAR in the hyperopic group. CONCLUSIONS: The ReSTOR® SN6AD3 intraocular lens in refractive lens exchange demonstrated good safety, efficacy, and predictability in correcting high ametropia and presbyopia.

  9. Alteraciones oculares y visuales en personas que trabajan con ordenador y son usuarias de lentes de contacto: una revisión bibliográfica

    Directory of Open Access Journals (Sweden)

    Ana Tauste Francés

    2014-01-01

    Full Text Available Fundamentos: El elevado número de personas que trabajando con ordenador utiliza lentes de contacto plantea la cuestión sobre si la suma de estos dos factores de riesgo para la salud visual puede originar un agravamiento del Síndrome Visual Informático. El objetivo de esta revisión es sintetizar el conocimiento científico sobre las alteraciones oculares y visuales relacionadas con la exposición a ordenador en usuarios de lentes de contacto. Métodos: Revisión de artículos científicos (2003-2013 en español e inglés, realizando una búsqueda bibliográfica, en Medline a través de PubMed y en Scopus. Resultados: La búsqueda inicial aportó 114 trabajos, después de aplicar criterios de inclusión/exclusión se incluyeron seis artículos. Todos ellos ponen de manifiesto que las alteraciones al utilizar el ordenador son más frecuentes en las personas usuarias de lentes de contacto, con prevalencias que oscilan de 95,0% al 16,9% que en las que no utilizan lentes de contacto, cuya prevalencia va del 57,5% al 9,9% y con una probabilidad cuatro veces mayor de padecer ojo seco [OR: 4,07 (IC 95%: 3,52-4,71]. Conclusiones: Las personas usuarias de ordenador padecen más alteraciones oculares y visuales cuando además son usuarias de lentes de contacto, pero los estudios son escasos y poco contundentes. Se precisan nuevas investigaciones que analicen la influencia según los tipos de lentes y sus condiciones de uso, tanto en la sintomatología como en la calidad de la lágrima y la superficie ocular. Las lentes de hidrogel de silicona son las que se asocian a mayor confort.

  10. Construcción de un microscopio simple con la lente de un teléfono celular

    Directory of Open Access Journals (Sweden)

    Ernesto Cyrulies

    2014-01-01

    Full Text Available En este artículo se propone la construcción de un microscopio simple recreando el principio de funcionamiento del microscopio de Leeuwenhoek, empleando en este caso una lente de cámara fotográfica de teléfono celular. El dispositivo permite observar y fotografiar estructuras celulares, cuyas imágenes ampliadas posibilitan ver ciertos detalles minúsculos. Se describe una manera sencilla de construirlo con materiales comunes. También se relata la implementación de la propuesta con alumnos de un instituto de formación docente y cuáles fueron sus resultados.

  11. Principales métodos para el cálculo de la lente intraocular después de la cirugía refractiva corneal

    Directory of Open Access Journals (Sweden)

    Taimí Cárdenas Díaz

    Full Text Available Con el surgimiento y el desarrollo de la cirugía refractiva corneal se han podido corregir quirúrgicamente a millones de pacientes con defectos refractivos. Con el cursar de los años comienza a opacarse fisiológicamente el cristalino, y disminuye la agudeza visual en estos pacientes a quienes se les modificó la curvatura corneal. Ante la necesidad de remover el cristalino y de calcular una lente intraocular de potencia adecuada para conseguir la emetropía, surge un nuevo reto a la Oftalmología. El cálculo de la lente intraocular en pacientes con cirugía refractiva corneal es mucho más complejo, pues además de tener longitudes axiales extremas, se añaden factores por la intervención previa que alteran la predictibilidad del resultado visual, con la aplicación de las fórmulas de cálculo de lente intraocular existentes. Se han descrito varios métodos que permiten determinar correctamente la potencia de la lente a implantar, dependiendo de los datos de los que se dispongan; de ahí la motivación para realizar una revisión de diferentes publicaciones con el propósito de describir los principales métodos empleados para realizar el cálculo de la lente intraocular en estos pacientes. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores.

  12. The Clinical and Molecular Characteristics of Adenocarcinoma Presented 
by Multi-focal GGO

    Directory of Open Access Journals (Sweden)

    Yang SONG

    2018-03-01

    Full Text Available Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs on computed tomography (CT image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS.

  13. Nonsyndromic Synchronous Multifocal Central Giant Cell Granulomas of the Maxillofacial Region: Report of a Case.

    Directory of Open Access Journals (Sweden)

    Anita Munde

    2015-04-01

    Full Text Available Central giant cell granuloma (CGCG is a benign proliferation of fibroblasts and multinucleated giant cells that almost exclusively occurs in the jaws. It commonly occurs in young adults showing a female predilection in the anterior mandible. Multifocal CGCGs in maxillofacial region are very rare and suggestive of systemic diseases such as hyperparathyroidism, an inherited syndrome such as Noonan-like multiple giant cell lesion syndrome or other disorders. Only 10 cases of multifocal CGCGs in the maxillofacial region without any concomitant systemic disease have been reported in the English literature. Here, we report an unusual case of 36 year-old female presented with non-syndromic synchronous, multifocal CGCGs in the left posterior mandible and left posterior maxilla without any concomitant systemic disease. Relevant literature is reviewed and the incidence, clinical features, radiological features, differential diagnosis and management of CGCGs are discussed.

  14. Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Arthur B. [Children' s Hospital of Wisconsin, Department of Radiology, Milwaukee, WI (United States); Nemours Children' s Health System/Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Awomolo, Agboola O. [Children' s Hospital of Wisconsin, Department of Radiology, Milwaukee, WI (United States); Szabo, Sara [Medical College of Wisconsin and Children' s Hospital of Wisconsin, Department of Pathology, Milwaukee, WI (United States); Cincinnati Children' s Hospital Medical Center, Division of Pathology and Laboratory Medicine, Cincinnati, OH (United States)

    2017-03-15

    Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions. (orig.)

  15. [The Clinical and Molecular Characteristics of Adenocarcinoma Presented 
by Multi-focal GGO].

    Science.gov (United States)

    Song, Yang; Liang, Naixin; Li, Shanqing

    2018-03-20

    Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs) on computed tomography (CT) image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS).
.

  16. Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome.

    Science.gov (United States)

    Meyers, Arthur B; Awomolo, Agboola O; Szabo, Sara

    2017-03-01

    Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions.

  17. N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

    Science.gov (United States)

    Ouldamer, Lobna; Goupille, Caroline; Vildé, Anne; Arbion, Flavie; Body, Gilles; Chevalier, Stephan; Cottier, Jean Philippe; Bougnoux, Philippe

    2016-01-01

    The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality. Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality. We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality. These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

  18. Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome

    International Nuclear Information System (INIS)

    Meyers, Arthur B.; Awomolo, Agboola O.; Szabo, Sara

    2017-01-01

    Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions. (orig.)

  19. Evaluation of rotation and visual outcomes after implantation of monofocal and multifocal toric intraocular lenses.

    Science.gov (United States)

    Garzón, Nuria; Poyales, Francisco; de Zárate, Begoña Ortíz; Ruiz-García, Jose Luis; Quiroga, Juan Antonio

    2015-02-01

    To evaluate rotational stability and its influence on postoperative visual acuity of different monofocal and multifocal toric intraocular lenses (IOLs). A prospective interventional study was designed. Ninety-one patients with a mean age of 71.65 ± 11.82 years were implanted with toric IOLs after phacoemulsification. Three monofocal toric IOLs (the Lentis LT [Oculentis, Berlin, Germany], enVista [Bausch & Lomb, Rochester, NY], and AcrySof IQ [Alcon Laboratories, Inc., Fort Worth, TX]) and one multifocal toric IOL (AcrySof IQ ReSTOR; Alcon Laboratories, Inc.) were implanted. Preoperative and postoperative images were taken to calculate the misalignment due to the marking method. To evaluate rotation in the different follow-up visits, another photograph was taken 1 hour and 1, 7 and 30 days postoperatively. Refraction, uncorrected distance visual acuity (UDVA), and corrected distance visual acuity were measured 30 days postoperatively. Postoperative UDVA was 0.1 logMAR or better in 64.6% of eyes implanted with monofocal IOLs and 46.4% of eyes implanted with multifocal IOLs. The enVista toric IOL showed the best UDVA compared to the other monofocal IOLs, with 81% of eyes with 0.1 logMAR or better. The mean misalignment in the total group studied was 0.07° ± 0.60°; 69.6% of monofocal IOLs and 67.9% of multifocal IOLs showed less than 5° of rotation. A correlation was found between postoperative UDVA and rotation in the monofocal and multifocal IOLs implanted (r = 0.439 [P < .011] and = 0.787 [P = .001], respectively). At 1 month postoperatively, UDVA was slightly more affected by IOL rotation in multifocal than monofocal toric IOLs. The marking method was also effective. Copyright 2015, SLACK Incorporated.

  20. Multifocality as a prognostic factor in breast cancer patients registered in Danish Breast Cancer Cooperative Group (DBCG) 1996-2001

    DEFF Research Database (Denmark)

    Joergensen, L.E.; Gunnarsdottir, K.A.; Lanng, C.

    2008-01-01

    The purpose of this study was to investigate the prognostic influence of multifocality in breast cancer patients. In a cohort of 7196 patients there were 945 patients with multifocality. We found no prognostic influence of multifocality on overall survival when controlling for known prognostic......, Gunnarsdottir KA, Rasmussen BB, Moeller S, Lanng C. The prognostic influence of multifocality in breast cancer patients. Breast 2004;13:188-193]....... factors. We found a small but significant influence on disease-free survival (HR=1.16 [1.03-1.31]) and a strong correlation between multifocality and known prognostic factors. This was in accordance with an earlier study done on a smaller population and in a different period of time [Pedersen L...

  1. Multifocal gastrointestinal stromal tumor (GIST) of the stomach in an 11-year-old girl

    International Nuclear Information System (INIS)

    Park, Jin; Rubinas, Tara C.; Fordham, Lynn A.; Phillips, J.D.

    2006-01-01

    A previously healthy 11-year-old girl presented with an 8-month history of anemia and left upper quadrant abdominal pain. US examination demonstrated a 9-cm cystic mass with a fluid-fluid level in the left upper quadrant with unclear organ of origin. Abdominal MR imaging demonstrated a complex cystic mass, likely arising from the stomach. Additional T2 hyperintense submucosal lesions were identified in the gastric wall. Surgical excision confirmed the diagnosis of multifocal gastric gastrointestinal stromal tumor (GIST). MR imaging was helpful in suggesting a gastric origin of the primary mass and in demonstrating multifocal disease within the stomach. (orig.)

  2. Multifocal fibrosclerosis: a new case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Kader Karli; Oguz, Oguzhan; Cila, Aysenur; Oto, Aytekin [Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Kiratli, Hayyam [Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Gokoz, Aytac [Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara (Turkey)

    2002-05-01

    A case of multifocal fibrosclerosis is presented with MR images. Bilateral sclerosing orbital pseudotumor invading cavernous sinuses were the presenting disorder. Magnetic resonance imaging showed involvement of paranasal sinuses bilaterally and multiple supratentorial dural masses. Retroperitoneal fibrosis was associated with the condition. Multifocal involvement should be considered in patients with sclerosing orbital pseudotumor and an imaging approach should be performed on the appropriate clinical condition to document possible coexistence of other disorders including retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, and Riedel's thyroiditis (orig.)

  3. [Halos and multifocal intraocular lenses: origin and interpretation].

    Science.gov (United States)

    Alba-Bueno, F; Vega, F; Millán, M S

    2014-10-01

    To present the theoretical and experimental characterization of the halo in multifocal intraocular lenses (MIOL). The origin of the halo in a MIOL is the overlaying of 2 or more images. Using geometrical optics, it can be demonstrated that the diameter of each halo depends on the addition of the lens (ΔP), the base power (P(d)), and the diameter of the IOL that contributes to the «non-focused» focus. In the image plane that corresponds to the distance focus, the halo diameter (δH(d)) is given by: δH(d)=d(pn) ΔP/P(d), where d(pn) is the diameter of the IOL that contributes to the near focus. Analogously, in the near image plane the halo diameter (δH(n)) is: δH(n)=d(pd) ΔP/P(d), where d(pd) is the diameter of the IOL that contributes to the distance focus. Patients perceive halos when they see bright objects over a relatively dark background. In vitro, the halo can be characterized by analyzing the intensity profile of the image of a pinhole that is focused by each of the foci of a MIOL. A comparison has been made between the halos induced by different MIOL of the same base power (20D) in an optical bench. As predicted by theory, the larger the addition of the MIOL, the larger the halo diameter. For large pupils and with MIOL with similar aspheric designs and addition (SN6AD3 vs ZMA00), the apodized MIOL has a smaller halo diameter than a non-apodized one in distance vision, while in near vision the size is very similar, but the relative intensity is higher in the apodized MIOL. When comparing lenses with the same diffractive design, but with different spherical-aspheric base design (SN60D3 vs SN6AD3), the halo in distance vision of the spherical MIOL is larger, while in near vision the spherical IOL induces a smaller halo, but with higher intensity due to the spherical aberration of the distance focus in the near image. In the case of a trifocal-diffractive IOL (AT LISA 839MP) the most noticeable characteristic is the double-halo formation due to the 2 non

  4. A Rare Multifocal Pattern of Type 2 Autoimmune Pancreatitis with Negative IgG4: A Potential Diagnostic Pitfall That May Mimic Multifocal Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Partha Hota

    2018-02-01

    Full Text Available Autoimmune pancreatitis (AIP is an increasingly recognized form of acute pancreatitis characterized by obstructive jaundice with a rapid and dramatic treatment response to steroid therapy. Recently, AIP has been divided into two distinct phenotypes: lymphoplasmocytic sclerosing pancreatitis AIP (type 1 and idiopathic duct-centric pancreatitis AIP (type 2; each of which have their own distinct demographics, diagnostic criteria, and histopathological features. We report, to the best of our knowledge, the first case of a multifocal pattern of type 2 AIP characterized with both CT and MR imaging. This rare imaging pattern of AIP may mimic the appearance of more worrisome malignant etiologies such as multifocal pancreatic adenocarcinoma or lymphoma, with overlapping imaging characteristics potentially complicating or delaying diagnosis. Therefore, recognition of this atypical pattern of AIP and avoidance of this potential diagnostic pitfall is crucial.

  5. Experiencia con la lente intraocular RAYNER 620H Experience gained with the use of intraocular lens RAYNER 620 H

    Directory of Open Access Journals (Sweden)

    Juan Raúl Hernández Silva

    2008-06-01

    Full Text Available Un importante eslabón en el progreso alcanzado en la cirugía de cataratas, está fundamentado en el desarrollo industrial paralelo que ha ocurrido durante los últimos años con la introducción de nuevos modelos de lentes intraoculares, como el Rayner 620 H; el perfeccionamiento del instrumental quirúrgico, sistemas de aspiración e irrigación bimanual y bisturí con la medida exacta para colocar el inyector de la lente intraocular. La lente intraocular Rayner 620H significó un gran paso para la facoemulsificación y el control de la opacidad de la cápsula posterior posoperatoria por el diseño peculiar de su óptica y hápticos, que permiten un implante seguro, fácil y una incisión mínima. Se realizó un estudio prospectivo y descriptivo, cuyo universo de estudio fueron 28 ojos con diagnóstico de cataratas a los cuales se les realizó facoemulsificación con implante de lente intraocular Rayner 620 H, en el Centro de Microcirugía Ocular del Instituto Cubano de oftalmología "Ramón Pando Ferrer" en el período comprendido entre junio de 2006 a febrero de 2007. El grupo de edades donde se encontró el de mayor número de pacientes fue en el de más de 60 años. En todos los casos hubo un aumento significativo de la agudeza visual sin corrección y con ella, del preoperatorio al posoperatorio. Hubo un aumento del cilindro queratométrico del preoperatorio al posoperatorio, pero este fue mínimo La pérdida de células endoteliales fue baja del preoperatorio al posoperatorio, respectivamente. No hubo ninguna complicación durante la cirugía ni después de esta. Evaluamos como satisfactoria la efectividad del lente intraocular Rayner 620 H, por el aumento de la agudeza visual del paciente, el bajo astigmatismo inducido, mejoría del campo visual por confrontación, mínima pérdida de células endoteliales, y ausencia de complicaciones y de deslumbramiento posoperatorio en los pacientes.An important link in the advances made by the

  6. Apport de l’IRM dans la prise en charge des compressions médullaires lentes non traumatiques

    Science.gov (United States)

    Badji, Nfally; Deme, Hamidou; Akpo, Geraud; Ndong, Boucar; Toure, Mouhamadou Hamine; Diop, Sokhna Ba; Niang, El Hadji

    2016-01-01

    Les compressions médullaires lentes sont dues au développement dans le canal médullaire d’une lésion expansive. C’est une pathologie très fréquente dont le diagnostic est essentiellement clinique. L’imagerie par résonnance magnétique occupe une place incontournable dans le diagnostic de localisation et la recherche étiologique. En Europe l’étiologie tumorale est prépondérante. Le but de cette étude était de décrire les aspects IRM des compressions médullaires lentes et de déterminer le profil étiologique. Il s’agit d’une étude rétrospective portant sur 97 observations colligées au service de radiologie du CHUN de Fann sur une période de 30 mois (du 08/03/10 au 29/09/12). On été inclus dans l’étude, tous les patients adressés pour un tableau de compression médullaire lente survenu dans un contexte non traumatique. L’âge moyen des patients était de 42,6 ans avec des extrêmes compris entre 04 mois et 85 ans. Nous avons étudié la topographie des lésions (étage rachidien, compartiments canalaires) leur rehaussement et les critères d’orientation étiologique. Le protocole d’examen permettait la réalisation de séquence pondérées T1 sans avec injection de gado, T2, STIR et T2 DRIVE centrées sur les niveaux lésionnels ou les zones suspectes. L’IRM a permis de préciser le siège exact et l’étendue des lésions. L’atteinte du rachis dorsal représentait 42% des cas, suivi du rachis cervical avec 32% des cas. Les atteintes lombo-sacrées et pluri-étagées représentaient respectivement 18% et 08% des cas. Les lésions extradurales représentaient 87% des cas, suivi des lésions intradurales extramédullaires avec 08% des cas et des lésions intramédullaires dans 05% des cas. La particularité du profil étiologique de notre étude est la prédominance des épidurites infectieuses et la fréquence relative des épidurites métastatiques comparée aux séries occidentales. L’IRM vertébro-médullaire occupe

  7. Unusually high incidence of multifocal epithelial hyperplasia in children of the Nahuatl population of Mexico.

    Science.gov (United States)

    Ledesma-Montes, Constantino; Mendez-Mendoza, Amilcar

    2017-01-01

    Multifocal epithelial hyperplasia is an uncommon disease of the oral mucosa caused by the human papilloma virus. To study the clinical and pathological findings of multifocal epithelial hyperplasia detected during an oral examination of 343 Mexican Nahuatl children from a single primary school in El Paso de Cupilco, Mexico. A thorough oral examination was performed in all children and clinical data (age, gender, location and number of lesions) were documented and analyzed. Multifocal epithelial hyperplasia was diagnosed in 110 of the 343 children (32.3%). The ages of the children varied from 5 to 15 years, and of these, 56.3% were girls. The lesions were asymptomatic, 0.2 to 3.0 cm in diameter, soft, round to oval, smooth surfaced, sessile papulonodules, similar in colour to that of the surrounding mucosa. The lesions were commonly seen on the buccal mucosa and tongue, and most affected children (85%) had less than 5 lesions. Children in the 7 to 10 years age group were most often affected. Human papillomavirus typing was not done owing to a lack of facilities. There is a high incidence of multifocal epithelial hyperplasia in Nahuatl children with a predilection for females.

  8. Chimeric immune receptors (CIRs) specific to JC virus for immunotherapy in progressive multifocal leukoencephalopathy (PML)

    NARCIS (Netherlands)

    W. Yang; E.L. Beaudoin; L. Lu; R.A. Du Pasquier (Renaud); M.J. Kuroda; R.A. Willemsen (Ralph); I.J. Koralnik; R.P. Junghans

    2007-01-01

    textabstractProgressive multifocal leukoencephalopathy (PML) is a deadly brain disease caused by the polyomavirus JC (JCV). The aim of this study is to develop 'designer T cells' armed with anti-JCV TCR-based chimeric immune receptors (CIRs) by gene modification for PML immunotherapy. Two T cell

  9. Right ventricular lipomatous mass and biventricular multifocal fat in a young woman: A case report

    International Nuclear Information System (INIS)

    Lee, Bo Rahm; Park, Jae Hyeong; Ahn, Kye Taek; Kim, Song Soo; Jeong, Jin Ok; Choi, Si Wan; Jin, Seon Ah; Lee, Jae Hwan

    2015-01-01

    Cardiac lipoma is a rare neoplasm of encapsulated mature adult adipose tissue. It is usually asymptomatic, but it may be related to hemodynamic obstruction depending on its location. We report a typical case of right ventricular lipomatous mass and multifocal fat infiltration of both ventricles, which were detected incidentally in a young woman.

  10. Multifocal choroiditis as the first sign of systemic sarcoidosis associated with pembrolizumab

    Directory of Open Access Journals (Sweden)

    Qu-Knafo Lise

    2017-04-01

    Conclusions and importance: Pembrolizumab is an immune checkpoint inhibitor therapy used in the treatment of metastatic melanoma. We report a pembrolizumab-associated sarcoidosis revealed by a panuveitis with multifocal choroiditis. Physicians should be aware of the potential inflammatory and autoimmune disease that may be induced by immunomodulatory therapies.

  11. The effect of high- to low-altitude adaptation on the multifocal electroretinogram

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Sander, Birgit; Zubieta-Calleja, Gustavo

    2009-01-01

    PURPOSE: To examine variations in retinal electrophysiology assessed by multifocal electroretinogram (mfERG) during acclimatization of native highlanders to normobaric normoxia at sea level. METHODS: Eight healthy residents of the greater La Paz area in Bolivia (3600 m above sea level) were...

  12. Evaluation of refractive correction for standard automated perimetry in eyes wearing multifocal contact lenses

    Directory of Open Access Journals (Sweden)

    Kazunori Hirasawa

    2017-10-01

    Full Text Available AIM: To evaluate the refractive correction for standard automated perimetry (SAP in eyes with refractive multifocal contact lenses (CL in healthy young participants. METHODS: Twenty-nine eyes of 29 participants were included. Accommodation was paralyzed in all participants with 1% cyclopentolate hydrochloride. SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions: monofocal CL corrected for near distance (baseline; multifocal CL corrected for distance (mCL-D; and mCL-D corrected for near vision using a spectacle lens (mCL-N. Primary outcome measures were the foveal threshold, mean deviation (MD, and pattern standard deviation (PSD. RESULTS: The foveal threshold of mCL-N with both the 24-2 and 10-2 protocols significantly decreased by 2.2-2.5 dB CONCLUSION: Despite the induced mydriasis and the optical design of the multifocal lens used in this study, our results indicated that, when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs, distance correction without additional near correction is to be recommended.

  13. Radioembolization After Portal Vein Embolization in a Patient with Multifocal Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Burgmans, Mark C.; Irani, Farah G.; Chan, Wan Ying; Teo, Terence K.; Kao, Yung Hsiang; Goh, Anthony S.W.; Chow, Pierce K.; Lo, Richard H.

    2012-01-01

    Radioembolization is an effective locoregional therapy for patients with intermediate or advanced stage hepatocellular carcinoma (HCC). It has been shown that radioembolization is safe in patients with portal vein thrombosis. This case report describes safe radioembolization after portal vein embolization in a patient with multifocal HCC.

  14. Exploring the methods of data analysis in multifocal visual evoked potentials

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; Santiago de Abreu, Lucimar; Fraser, C.

    2016-01-01

    Purpose: The multifocal visual evoked potential (mfVEP) provides a topographical assessment of visual function, which has already shown potential for use in patients with glaucoma and multiple sclerosis. However, the variability in mfVEP measurements has limited its broader application. The purpo...

  15. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Haakma, Wieke; Jongbloed, Bas A.; Froeling, Martijn

    2017-01-01

    Objectives To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. Methods We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls...

  16. Correction to: Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event.

    Science.gov (United States)

    Berger, Joseph R; Malik, Vineeta; Lacey, Stuart; Brunetta, Paul; Lehane, Patricia B

    2018-04-10

    The article "Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event," written by Joseph R. Berger, Vineeta Malik, Stuart Lacey, Paul Brunetta, and Patricia B. Lehane 3 , was originally published electronically on the publisher's internet portal (currently SpringerLink).

  17. Application of serum natalizumab levels during plasma exchange in MS patients with progressive multifocal leukoencephalopathy

    NARCIS (Netherlands)

    Vennegoor, A.; Rispens, T.; van Oosten, B.W.; Wattjes, M.P.; Wondergem, M.J.; Teunissen, C.E.; van der Kleij, D.; Uitdehaag, B.M.J.; Polman, C.H.; Killestein, J.

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) is a severe complication of natalizumab treatment. Restoring immune function by plasmapheresis/immunoadsorption (PLEX/IA) is important for the outcome of PML. We report on four multiple sclerosis (MS) patients whom developed PML during natalizumab

  18. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    International Nuclear Information System (INIS)

    Piddo, C.; Reed, M.H.; Black, G.B.

    2000-01-01

    A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

  19. Effect of Unifocal versus Multifocal Lenses on Cervical Spine Posture in Patients with Presbyopia.

    Science.gov (United States)

    Abbas, Rami L; Houri, Mohamad T; Rayyan, Mohammad M; Hamada, Hamada Ahmad; Saab, Ibtissam M

    2018-04-04

    There are many environmental considerations which may or may not lead to the development of faulty cervical mechanics. The design of near vision lenses could contribute to the development of such cervical dysfunction and consequently neck pain. Decision making regarding proper type of lens prescription seems important for presbyopic individuals. To investigate the effect of unifocal and multifocal lenses on cervical posture. Thirty subjects (18 females and 12 males) participated in the study with an age range from 40 to 64 years. Each subject wore consequently both unifocal and multifocal lenses randomly while reading. Then lateral cervical spine X-ray films were taken for each subject during each lens wearing. X-ray films were analyzed with digital software (Autocad software, 2 D) to measure segmental angles of the cervical vertebrae (Occiput/C1, C1/C2, C2/C3, C3/C4, C4/C5, C5/C6, C6/C7, C3/C7, C0/C3, and occiput/C7). Higher significant extension angle in the segments C0/C7, C1/C2, C5/C6, C6/C7, and C3/C7 (p<0.05) during multifocal lenses wearing were observed in contrast with higher flexion angle between C3/C4 and C4/C5 (p<0.05) with unifocal lenses wear. Multifocal lens spectacles produces increased extension in the cervical vertebrae angles when compared with the use of unifocal lenses.

  20. Multifocal osteolysis following limb-sparing procedures: imaging findings and a review of the literature

    International Nuclear Information System (INIS)

    Kaste, S.C.; Rao, B.N.; Lynch, M.H.; Parham, D.M.; Meyer, W.H.

    1996-01-01

    Limb-sparing procedures utilizing endoprostheses improve both the quality of life and functional level of patients treated for primary bone sarcomas. Herein, we present the imaging findings of an uncommon cause of prosthetic failure, i. e., foreign body reaction, manifested by progressive multifocal osteolysis along the prosthetic femoral shaft. (orig.). With 3 figs

  1. Late hemodynamic failure following percutaneous transluminal angioplasty for long and multifocal femoropopliteal stenoses

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Holstein, P

    1991-01-01

    separate segments were dilated. Following 98% initial technical success, 3-year patency was 68% for single short stenoses, as opposed to 20% for long and multifocal stenoses (p = 0.05, logrank test). Antiplatelet therapy with acetylsalicyclic acid was not found to influence occurrence of restenosis...

  2. Effect of multizone refractive multifocal contact lenses on standard automated perimetry.

    Science.gov (United States)

    Madrid-Costa, David; Ruiz-Alcocer, Javier; García-Lázaro, Santiago; Albarrán-Diego, César; Ferrer-Blasco, Teresa

    2012-09-01

    The aim of this study was to evaluate whether the creation of 2 foci (distance and near) provided by multizone refractive multifocal contact lenses (CLs) for presbyopia correction affects the measurements on Humphreys 24-2 Swedish interactive threshold algorithm (SITA) standard automated perimetry (SAP). In this crossover study, 30 subjects were fitted in random order with either a multifocal CL or a monofocal CL. After 1 month, a Humphrey 24-2 SITA standard strategy was performed. The visual field global indices (the mean deviation [MD] and pattern standard deviation [PSD]), reliability indices, test duration, and number of depressed points deviating at P0.5% on pattern deviation probability plots were determined and compared between multifocal and monofocal CLs. Thirty eyes of 30 subjects were included in this study. There were no statistically significant differences in reliability indices or test duration. There was a statistically significant reduction in the MD with the multifocal CL compared with monfocal CL (P=0.001). Differences were not found in PSD nor in the number of depressed points deviating at P0.5% in the pattern deviation probability maps studied. The results of this study suggest that the multizone refractive lens produces a generalized depression in threshold sensitivity as measured by the Humphreys 24-2 SITA SAP.

  3. The Effects of Hashimoto Thyroiditis on Lymph Node Metastases in Unifocal and Multifocal Papillary Thyroid Carcinoma

    Science.gov (United States)

    Zhu, Feng; Shen, Yi Bin; Li, Fu Qiang; Fang, Yun; Hu, Liang; Wu, Yi Jun

    2016-01-01

    Abstract The purpose of this study was to investigate the risk factors for central and lateral neck lymph node metastases in papillary thyroid carcinoma (PTC) and multifocal papillary thyroid carcinoma (MPTC), particularly when associated with Hashimoto thyroiditis (HT). A retrospective analysis of 763 consecutive patients who underwent total thyroidectomy with bilateral central neck dissection in the First Affiliated Hospital, College of Medicine, Zhejiang University between October 2011 and October 2014 was conducted. All patients had formal histological diagnoses of HT. Multivariable logistic regression analysis was performed to identify risk factors of neck lymph node metastases. Our study identified 277 PTC patients with HT and showed comparatively low rates of central lymph node metastases (CLNM) compared with the PTC patients without HT (37.2% versus 54.7%, P thyroid peroxidase antibody >140 IU/mL was established as the most sensitive and specific level for the prediction of MPTC based on receiver operating characteristic curve analyses. Thyroid peroxidase antibody, age, tumor size, and multifocality exhibited the ability to predict CLNM in PTC with HT patients with an area under the curve of 81.1% based on a multivariate model. Hashimoto thyroiditis was associated with increased prevalences of multifocality and capsular invasion. In contrast, HT was associated with a reduced risk of CLNM in PTC and MPTC patients, which indicated a potential protective effect. We found that the prognostic prediction model was applicable for predicting multifocality and CLNM in PTC patients with HT. PMID:26871795

  4. Incidental caseating granuloma of thyroid gland presenting with concomitant Graves′ disease and multifocal papillary microcarcinoma

    Directory of Open Access Journals (Sweden)

    Muneera A Al Shareef

    2013-01-01

    Full Text Available A 36-year-old Saudi woman presented with symptoms and signs of hyperthyroidism and was diagnosed to have Graves′ disease. She was initially treated with antithyroid medications with no response. Subsequently, she underwent a total thyroidectomy. The histopathology of the specimen revealed caseating granulomatous thyroid suggestive of tuberculosis and multifocal papillary thyroid microcarcinoma

  5. The spatial resolution of the porcine multifocal electroretinogram for detection of laser-induced retinal lesions

    DEFF Research Database (Denmark)

    Kyhn, Maria Voss; Kiilgaard, Jens Folke; Scherfig, Erik

    2008-01-01

    This study aimed to investigate the spatial resolution of a porcine multifocal electroretinogram (mfERG) protocol by testing its ability to detect laser-induced retinal lesions. Furthermore, we wanted to describe time-dependent changes in implicit time and amplitude of the different mfERG peaks...

  6. Multifocal fibrosclerosis presenting as Grave's orbitopathy. Bilateral exophthalmos associated with retroperitoneal and sellar fibrosis

    NARCIS (Netherlands)

    van der Pol, R.; Nieuwenhuis, M. G.; Mourits, M. P.

    1999-01-01

    BACKGROUND: Multifocal fibrosclerosis (MF) is a rare disease that may be misdiagnosed as Graves' orbitopathy. The combination of localisations of MF presented here has not been reported before. CASE REPORT: A 44-year-old man was referred with progressive bilateral exophthalmos. CT of his chest and

  7. The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES)

    NARCIS (Netherlands)

    Haeusler, Julia; Ranft, Andreas; Boelling, Tobias; Gosheger, Georg; Braun-Munzinger, Gabriele; Vieth, Volker; Burdach, Stefan; van den Berg, Henk; Juergens, Heribert; Dirksen, Uta

    2010-01-01

    The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES) was investigated. We analyzed 120 patients registered into the European Ewing Tumor Working Initiative of National Groups (EURO-E.W.I.N.G. 99) trial at the trial center of Muenster from 1998 to

  8. Primary Disseminated Multifocal Ewing Sarcoma: Results of the Euro-EWING 99 Trial

    NARCIS (Netherlands)

    Ladenstein, Ruth; Pötschger, Ulrike; Le Deley, Marie Cécile; Whelan, Jeremy; Paulussen, Michael; Oberlin, Odile; van den Berg, Henk; Dirksen, Uta; Hjorth, Lars; Michon, Jean; Lewis, Ian; Craft, Alan; Jürgens, Heribert

    2010-01-01

    Purpose To improve the poor prognosis of patients with primary disseminated multifocal Ewing sarcomas (PDMES) with a dose-intense treatment concept. Patients and Methods From 1999 to 2005, 281 patients with PDMES were enrolled onto the Euro-EWING 99 R3 study. Median age was 16.2 years (range, 0.4 to

  9. Contactin-1 and Neurofascin-155/-186 Are Not Targets of Auto-Antibodies in Multifocal Motor Neuropathy.

    Directory of Open Access Journals (Sweden)

    Kathrin Doppler

    Full Text Available Multifocal motor neuropathy is an immune mediated disease presenting with multifocal muscle weakness and conduction block. IgM auto-antibodies against the ganglioside GM1 are detectable in about 50% of the patients. Auto-antibodies against the paranodal proteins contactin-1 and neurofascin-155 and the nodal protein neurofascin-186 have been detected in subgroups of patients with chronic inflammatory demyelinating polyneuropathy. Recently, auto-antibodies against neurofascin-186 and gliomedin were described in more than 60% of patients with multifocal motor neuropathy. In the current study, we aimed to validate this finding, using a combination of different assays for auto-antibody detection. In addition we intended to detect further auto-antibodies against paranodal proteins, specifically contactin-1 and neurofascin-155 in multifocal motor neuropathy patients' sera. We analyzed sera of 33 patients with well-characterized multifocal motor neuropathy for IgM or IgG anti-contactin-1, anti-neurofascin-155 or -186 antibodies using enzyme-linked immunosorbent assay, binding assays with transfected human embryonic kidney 293 cells and murine teased fibers. We did not detect any IgM or IgG auto-antibodies against contactin-1, neurofascin-155 or -186 in any of our multifocal motor neuropathy patients. We conclude that auto-antibodies against contactin-1, neurofascin-155 and -186 do not play a relevant role in the pathogenesis in this cohort with multifocal motor neuropathy.

  10. Diffusion-weighted imaging in patients with progressive multifocal leukoencephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Cosottini, M. [University of Pisa, Department of Neuroscience, Pisa (Italy); Service of Neuroradiology AO, Pisa (Italy); Tavarelli, C.; De Cori, S.; Bartolozzi, C. [University of Pisa, Department of Radiology, Pisa (Italy); Del Bono, L.; Doria, G. [Unit of Infectious Diseases AO, Pisa (Italy); Giannelli, M. [Unit of Medical Physics, Pisa (Italy); Michelassi, M.C. [Service of Neuroradiology AO, Pisa (Italy); Murri, L. [University of Pisa, Department of Neuroscience, Pisa (Italy)

    2008-05-15

    Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system due to JC polyoma virus infection of oligodendrocytes. PML develops in patients with impaired T-cell function as occurs in HIV, malignancy or immunosuppressive drugs users. Until now no imaging methods have been reported to correlate with clinical status. Diffusion-weighted imaging (DWI) is a robust MRI tool in investigating white matter architecture and diseases. The aim of our work was to assess diffusion abnormalities in focal white matter lesions in patients with PML and to correlate the lesion load measured with conventional MRI and DWI to clinical variables. We evaluated eight patients with a biopsy or laboratory-supported diagnosis of PML. All patients underwent MRI including conventional sequences (fluid attenuated inversion recovery-FLAIR) and DWI. Mean diffusivity (MD) maps were used to quantify diffusion on white matter lesions. Global lesion load was calculated by manually tracing lesions on FLAIR images, while total, central core and peripheral lesion loads were calculated by manually tracing lesions on DWI images. Lesion load obtained with the conventional or DWI-based methods were correlated with clinical variables such as disease duration, disease severity and survival. White matter focal lesions are characterized by a central core with low signal on DWI images and high MD (1.853 x 10{sup -3} mm2/s), surrounded by a rim of high signal intensity on DWI and lower MD (1.1 x 10{sup -3} mm2/s). The MD value of normal-appearing white matter is higher although not statistically significant (0.783 x 10{sup -3} mm2/s) with respect to control subjects (0.750 x 10{sup -3} mm2/s). Inter-rater correlations of global lesion load between FLAIR (3.96%) and DWI (3.43%) was excellent (ICC =0.87). Global lesion load on FLAIR and DWI correlates with disease duration and severity (respectively, p = 0.037, p = 0.0272 with Karnofsky scale and p = 0.0338 with

  11. Adaptação de lentes de contato após cirurgia refrativa Contact lens fitting after refractive surgery

    Directory of Open Access Journals (Sweden)

    Adimara da Candelária Renesto

    2005-02-01

    Full Text Available OBJETIVO: Avaliar a adaptação e o uso de lente de contato em pacientes que foram submetidos à cirurgia refrativa. MÉTODOS: Foi realizado estudo retrospectivo de 53 pacientes submetidos à cirurgia refrativa, que posteriormente passaram a usar lente de contato, no período de 1999 a 2003. Foram avaliados a ametropia prévia, tipo de cirurgia realizada, refração pós-cirúrgica, equivalente esférico pós-cirurgia, ceratometria pós-operatória, curva base da lente adaptada, tipo de lente de contato adaptada, acuidade visual com óculos no pós-operatório, acuidade visual final com lente de contato, complicações e motivo da interrupção do uso. O tempo de seguimento variou de 1 mês a 84 meses (média de 42,5 meses. RESULTADOS: Dos 53 pacientes analisados, 19 pacientes foram submetidos a LASIK (Laser Assisted in Situ Keratomileusis, 29 pacientes foram submetidos à RK (ceratotomia radial, 4 pacientes foram submetidos a PRK (ceratectomia fotoablativa e em um paciente não foi possível obter o tipo de cirurgia realizado. Em 61,29% dos pacientes, (57 olhos de um total de 93, foram adaptadas lentes de contato rígidas gás-permeáveis esféricas. Houve melhora da acuidade visual em 60,21% dos casos (AV>20/40, com poucas complicações. CONCLUSÃO: Devido ao número cada vez maior de cirurgias refrativas realizadas, espera-se que aumente o número de pacientes insatisfeitos com o resultado no pós-operatório e para os quais o uso de lentes de contato venha a ser a melhor opção. A adaptação de lentes de contato pós-cirurgia refrativa exige conhecimento e dedicação e em geral tem bons resultados principalmente pela melhora da acuidade visual.PURPOSE: To evaluate the fitting and use of contact lens in patients submitted to refractive surgery. METHODS: This was a retrospective study in 53 patients submitted to refractive surgery who later started to use contact lens, from 1999 to 2003. The parameters were: previous ametropia, refractive

  12. Revisión bibliográfica sobre los beneficios del coloreado de las lentes destinadas a las actividades deportivas

    Directory of Open Access Journals (Sweden)

    Carlos Montaner Sesmero

    2010-09-01

    Full Text Available El desarrollo de productos comerciales específicos para cada usuario es una línea de actuación preferente para cada vez más empresas del sector deportivo. Algunos de estos productos personalizados, como es el caso de las gafas deportivas con lentes coloreadas, ofrecen prestaciones que aseguran un mejor confort y/o rendimiento deportivo en determinados contextos. Sin embargo, la base científica que apoya el beneficio de dichos artículos es desconocida. Así, el propósito de este estudio es realizar una revisión del trabajo científico publicado que explique el posible beneficio que puede suponer el uso de un tipo de coloreado u otro en las lentes de las gafas deportivas. Para ello, se ha llevado a cabo una revisión bibliográfica centrada en aspectos de confort y de rendimiento visual en la práctica deportiva, a través de bases documentales científicas, de páginas web y de normativa referente al uso de lentes deportivas. La principal conclusión que se puede extraer es que el estado del arte ofrece una limitada base científica para soportar los productos existentes en el mercado, así como para proponer lentes de color para deportes concretos. Queda establecido que a través de determinados filtros coloreados puedan mejorarse los tiempos de reacción y la habilidad visual, pero en caso de abordar esta línea de I+D, sería incluso necesario poner a punto métodos de medida adecuados.

  13. Vitrectomía pars plana y reimplante de lente intraocular en surco Pars plana vitrectomy and intraocular lens repositioning in the sulcus

    Directory of Open Access Journals (Sweden)

    Alejandro Guerra García

    2010-01-01

    Full Text Available Se presentó un caso de lente intraocular luxado a vítreo en paciente con conteo bajo de células endoteliales e intolerancia a lentes de contacto. Se practicó vitrectomía pars plana con reimplante de lente en surco ciliar con el objetivo de demostrar la fiabilidad de la técnica para casos que presenten condiciones adecuadas y situaciones especiales. Se revisó la bibliografía para conocer las tendencias actuales con respecto al manejo de esta patología. El paciente alcanzó una agudeza visual de 20/30. El lente permaneció estable en el surco 3 meses después de practicada la vitrectomía. El manejo de esta entidad debe ser personalizado. La técnica utilizada debe ser siempre la primera opción de tratamiento y parece ser segura en casos cuidadosamente escogidos.A case of dislocated intraocular lens moved to the vitreous cavity in a patient with low endothelial cell count and contact lens intolerance was reported. A pars plana vitrectomy with lens repositioning was performed to demonstrate the safety of this technique for some special cases under adequate conditions. The literature was reviewed to learn about the current management of this pathology. Finally, patient's best visual acuity was 20/30. The stability of the lens was confirmed three month l after the vitrectomy. Management of this disorder should be customized. This technique should be considered as the first option of treatment and seems to be safe in selected cases.

  14. Comparison of patient-reported late treatment toxicity (LENT-SOMA) with quality of life (EORTC QLQ-C30 and QLQ-H and N35) assessment after head and neck radiotherapy

    International Nuclear Information System (INIS)

    Ho, Kean Fatt; Farnell, Damien J.J.; Routledge, Jacqueline A.; Burns, Meriel P.; Sykes, Andrew J.; Slevin, Nick J.; Davidson, Susan E.

    2010-01-01

    Purpose: The patient's role in toxicity reporting is increasingly acknowledged but requires the adaptation and validation of toxicity reporting instruments for patient use as most toxicity scales are designed for physician use. Recording of radiotherapy related late toxicity is important and needs to be improved. A patient-scored symptom questionnaire of late treatment effects using LENT-SOMA was compared with a recognised quality of life tool (EORTC QLQ-C30/H and N35). Materials/methods: LENT-SOMA and EORTC QLQ-C30 patient questionnaires were prospectively completed by 220 head and neck cancer patients over 3 years and 72 completed EORTC QLQ-H and N35 questionnaires at 2 years post-radiotherapy. Results: Endpoints common to both questionnaires (pain, swallowing, dental pain, dry mouth, opening mouth, analgesics) were matched. Spearman rank correlation coefficients with ρ > 0.6 (P < 0.001) were obtained for all 'matched' scales except for analgesics scale, ρ = 0.267 (P < 0.05). There was good agreement between LENT-SOMA and EORTC QLQ-H and N35 except for analgesic endpoints. Global quality of life scores correlated negatively with average LENT-SOMA scores (P < 0.001). Significant differences in average LENT-SOMA scores between treatment modalities were found. The LENT-SOMA questionnaire has demonstrated a high Cronbach's α value (0.786) indicating good reliability. Conclusions: LENT-SOMA patient questionnaire results agreed well with those from the EORTC QLQ-H and N35 questionnaire for toxicity items where they could be compared explicitly, particularly for subjective endpoints. Patient-reported late toxicity had a negative impact on quality of life. The LENT-SOMA patient questionnaire is both reliable and sensitive to differences between patients treated with different modalities. A patient-based questionnaire is an important contributor to capturing late radiotherapy effects.

  15. Avaliação do nível de conhecimento quanto ao uso de lentes de contato entre os estudantes de medicina da Faculdade de Medicina do ABC

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    Giovana Arlene Fioravanti Lui

    2010-12-01

    Full Text Available OBJETIVO: Analisar o nível de conhecimento dos usuários de lentes de contato entre os estudantes de medicina da Faculdade de Medicina do ABC (SP quanto aos cuidados, formas de uso, às complicações e à aquisição das lentes. MÉTODOS: Foi aplicado um questionário a todos os alunos usuários de lentes de contato do 1º ao 6º ano de medicina da Faculdade de Medicina do ABC (SP, analisando-se por fim os resultados encontrados. Todos os questionários aplicados foram respondidos. RESULTADOS: 61 estudantes responderam ao questionário. 52,5% afirmaram já terem tido algum tipo de complicação ocular decorrente do uso de lentes de contato. Apesar de a maioria (70,5% estar satisfeito com o uso das lentes de contato, 67% dos que responderam ao questionário estão esperando o grau estabilizar para realizar cirurgia para correção de grau. CONCLUSÃO: Observou-se uma adaptação inadequada, aquisição de lentes de contato em ópticas ou farmácias e complicações oculares graves ocorreram em usuários de lentes de contato considerados diferenciados. Podemos concluir que o médico oftalmologista deverá dar mais atenção ao tema, para que haja menos complicações ao realizar adaptações de lentes de contato.

  16. Late radiation effects to the rectum and bladder in gynecologic cancer patients: the comparison of LENT/SOMA and RTOG/EORTC late-effects scoring systems

    International Nuclear Information System (INIS)

    Anacak, Yavuz; Yalman, Deniz; Oezsaran, Zeynep; Haydaroglu, Ayfer

    2001-01-01

    Purpose: To test the correlation of LENT/SOMA and RTOG/EORTC late-effect scales for rectum and bladder, 116 cases with gynecologic malignancies that were treated with radiotherapy were assessed with both scales. Methods and Materials: All cases had been treated at least 6 months before the date of assessment with external beam radiotherapy (50-54 Gy to midline) and 1-2 fractions of HDR brachytherapy (2x8.5 Gy to point-A for 32 inoperable cases; 1x9.25 Gy to 5-9 mm from the ovoid surface for 84 postoperative cases). The patients were questioned with both scales, and the correlation between the two scales was analyzed by Spearman's rho (rank correlation) test. Results: There were 64 cases with uterine cervix carcinoma and 52 cases with endometrium carcinoma, The overall (external + brachy) doses to ICRU points were 57.8±3.8 Gy for rectum and 59.3±4.9 Gy for bladder. The statistical analysis of LENT/SOMA and RTOG/EORTC scales revealed a very good correlation for rectum (r=0.81; p<0.01) and a good correlation for bladder (r=0.72; p<0.01). Conclusion: The LENT/SOMA system is a further step on the reporting of late radiation effects. Some modifications will improve its precision, and multicentric randomized studies are needed to test its validity

  17. Lentes de contato filtrantes coloridas nas discromatopsias: relato de casos Absorptive and colored contact lenses in color-vision defects: case report

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    Luciene Chaves Fernandes

    2003-06-01

    Full Text Available As autoras propõem a utilização de lentes de contato filtrantes coloridas para melhora da discriminação de cores e do ofuscamento, em portadores de discromatopsia, na impossibilidade de montagem de filtros coloridos em óculos. Foram adaptadas lentes de contato filtrantes coloridas em dois portadores de discromatopsias, um com deutanopia e outro com acromatopsia. No primeiro, adaptou-se lente rígida filtrante, de polimetilmetacrilato (PMMA, vermelha, no olho não dominante, com o objetivo de melhorar a discriminação de cores. No segundo, colocou-se lente filtrante gelatinosa, de uso diário, de coloração marrom escuro com pupila âmbar, visando melhorar o ofuscamento. No primeiro caso, o paciente manteve inalterada a acuidade visual e também o contraste, porém demonstrou melhora na discriminação das cores ao teste de PV-16. No segundo caso, houve melhora subjetiva acentuada do ofuscamento tanto em ambiente interno, como externo. A acuidade visual e a visão de cores permaneceram sem alterações. Os achados sugerem a possibilidade de contarmos com as lentes de contato filtrantes coloridas como importante auxílio para a melhora na discriminação de cores e ofuscamento, nas discromatopsias.The authors propose the use of absorptive and colored contact lenses as an aid to color defects in making color judgments and reduce glare sensitivity in dichromatic subjects, when the use of filter in glasses is not possible. Absorptive and colored contact lenses were adapted in two dichromatic subjects, one deutanope and the other with achromatopsia. In the former, a hard absorptive, red-colored, polymethacrylate lens was adapted monocularly, in the non-dominant eye to help color judgments. In the latter, a soft absorptive, dark brown-colored lens with amber pupil was worn in both eyes to reduce glare sensitivity. Subject # 1 remained with the same visual acuity and contrast sensitivity and demonstrated a better color perception on the PV-16

  18. Upper Extremity Multifocal Neuropathy in a 10-Year-Old Boy Associated With NS6S Disaccharide Antibodies.

    Science.gov (United States)

    Edelman, Frederick; Naddaf, Elie; Waclawik, Andrew J

    2015-06-01

    We present a 10-year-old boy with a predominantly motor multifocal neuropathy with demyelinating and axonal changes with sensory involvement, affecting only one upper extremity. Laboratory studies revealed an elevated titer of immunoglobulin M (IgM) antibodies against the NS6S antigen. He responded to treatment with high dose intravenous immunoglobulins. Focal or multifocal immune-mediated neuropathies are not common in children and may be underdiagnosed. © The Author(s) 2014.

  19. Optical implementation of multifocal programmable lens with single and multiple axes

    Energy Technology Data Exchange (ETDEWEB)

    Romero, Lenny A; Millan, Maria S; Perez-Cabre, Elisabet, E-mail: lenny.alexandra.romero@upc.edu [Optics and Optometry Dep. Technical University of Catalonia Violinista Vellsola 37, 08222 Terrassa (Spain)

    2011-01-01

    In this work we analyse the generation of a diffractive optical element (DOE) consisting of a multifocal Fresnel lens by means of an LCoS (liquid cristal on silicon) spatial light modulator (SLM). The multifocal lens is composed of a set of lenses of different focal length that share a common optical axis (coaxial combination) or have different axes in parallel (multi-axis combination). For both configurations, we present several ways to combine the phase distributions for three lenses with different focal lengths (f1, f2, f3), into a single-phase distribution addressed to the SLM. Numerical simulations were carried out along with the experimental analysis to corroborate the results.

  20. Multifocal oral melanoacanthoma associated with Addison's disease and hyperthyroidism: a case report.

    Science.gov (United States)

    Dantas, Thinali Sousa; Nascimento, Isabelly Vidal do; Verde, Maria Elisa Quezado Lima; Alves, Ana Paula Negreiros Nunes; Sousa, Fabrício Bitu; Mota, Mário Rogério Lima

    2017-01-01

    Oral melanoacanthoma is a mucocutaneous, pigmented, rare, benign, and probably reactive lesion. This paper reports for the first time in the literature a case of multifocal oral melanoacanthoma in a patient diagnosed with Addison's disease and concomitant Graves' disease with hyperthyroidism. The patient presented with oral pigmented lesions, which were hypothesized to be mucosal pigmentation associated with Addison's disease. Due to their unusual clinical pattern, these oral lesions were biopsied and diagnosed as oral melanoacanthoma on histopathology and immunohistochemistry for HMB-45. At the moment of this report, the patient was being treated for her systemic conditions, but the lesions had not regressed. Reactive hyperpigmentation of the skin and mucous membranes may be found in Addison's disease and hyperthyroidism. This case reinforces the hypothesis of a reactive nature for oral melanoacanthoma and highlights the need for investigation of endocrine disorders in patients with multifocal oral melanoacanthoma.

  1. [Follow-up on MEWDS by fundus perimetry and multifocal ERG with the SLO].

    Science.gov (United States)

    Bültmann, S; Martin, M; Rohrschneider, K

    2002-09-01

    Most conventional techniques for examination such as perimetry or ERG may not be sensitive enough to detect functional alterations due to MEWDS precisely. We report on a follow-up performed by fundus perimetry and the new technique of multifocal ERG using the scanning laser ophthalmoscope. A 24-year-old female patient (VA 0.2/0.8) was followed up for 7 weeks with these techniques as well as Octopus perimetry, fluorescence angiography, Ganzfeld ERG and biomicroscopy. Multifocal ERG stimulation (mfERG, Retiscan) was performed with the SLO. Visual acuity improved from 0.2 to 0.8 and the central relative scotoma disappeared while a relevant increase of P1-wave amplitudes in mfERG could be observed. Combining objective measurements from the fundus controlled SLO-mfERG and results from fundus perimetry enable good correlation of morphology and results, even for minor alterations of the macula only accessible by few established clinical examinations.

  2. Evaluation of refractive correction for standard automated perimetry in eyes wearing multifocal contact lenses.

    Science.gov (United States)

    Hirasawa, Kazunori; Ito, Hikaru; Ohori, Yukari; Takano, Yui; Shoji, Nobuyuki

    2017-01-01

    To evaluate the refractive correction for standard automated perimetry (SAP) in eyes with refractive multifocal contact lenses (CL) in healthy young participants. Twenty-nine eyes of 29 participants were included. Accommodation was paralyzed in all participants with 1% cyclopentolate hydrochloride. SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions: monofocal CL corrected for near distance (baseline); multifocal CL corrected for distance (mCL-D); and mCL-D corrected for near vision using a spectacle lens (mCL-N). Primary outcome measures were the foveal threshold, mean deviation (MD), and pattern standard deviation (PSD). The foveal threshold of mCL-N with both the 24-2 and 10-2 protocols significantly decreased by 2.2-2.5 dB ( P correction without additional near correction is to be recommended.

  3. An adult multifocal medulloblastoma with diffuse acute postoperative cerebellar swelling: immunohistochemical and molecular genetics analysis.

    Science.gov (United States)

    Balik, Vladimir; Trojanec, Radek; Holzerova, Milena; Tuckova, Lucie; Sulla, Igor; Megova, Magdalena; Vaverka, Miroslav; Hrabalek, Lumir; Ehrmann, Jiri

    2015-01-01

    Medulloblastoma (MB), the most common malignant tumor typically affecting children, occurs only exceptionally in adults. Multifocal presentation of this malignancy in adulthood is even much rarer—only four cases with favorable postoperative course have been reported, so far. The study illustrates a very rare rapid postoperative clinical deterioration due to diffuse cerebellar swelling (DCS) in an adult multifocal MB (MMB). To the best of their knowledge, authors for the first time performed genetic analysis of MMB and demonstrated expression patterns of selected markers that put the patient within the sonic hedgehog (SHH) molecular subgroup and at least partially explain her unsatisfactory clinical course. Herein, authors summarized the relevant literature concerning this issue with the aim to determine features that would facilitate diagnosis and therapy of such a scarce clinical entity.

  4. EFFECT 0F ISOTONIC AND ISOMETRIC EXERCISES ON INTRA OCULAR PRESSURE

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    Rajendra

    2015-10-01

    Full Text Available BACKGROUND: Intra O cular Pressure (IOP changes following dynamic (Isotonic or Isokinetic and static (Isometric exercise. AIM: To study the effect of dynamic and static exercises on IOP and blood pressure in the same subject following each type of exercise and to correlate the changes in BP to the changes in the IOP. MATERIALS AND METHODS: The study group consisted of 55 volunteers, visually normal as subjects, 30 boys and 25 girls in the age group of 18 to 20 years. Independent measurements of the IOP of each eye were obtained and BP was also measured in the resting state. Keelar Pulsair air i mpulse tonometer was used in all the subjects for IOP measurement. IOP was measured in the department of Ophthalmology, Teaching Hospital between 08AM to 10 AM on two consecutive mornings in a randomized manner. The subject undertook static exercise using the hand grip dynamometer and towards the end of the test, IOP and BP were measured. The next morning, resting IOP and the BP were measured and the subject undertook the dynamic exercise using the bicycle ergometer and the IOP’s and the BP were measured at the end of the test. STATISTICAL ANALYSIS : were done using Paired ‘t’ test. RESULTS: IOP decreased by 2.58±0.16 mmHg(R eye & 2.64±0.09 mmHg (L eye during exercise using Hand grip dynamometer and the systolic and diastolic blood pressures increased by 14 .73±0.87 & 12.98±1.01 mmHg respectively. The changes were statistically significant (P<0.001. IOP decreased by 2.55±0.07 mmHg(R eye & 2.49±0.1 mmHg(Leye following exercise using bicycle ergometer and the systolic increased by 15.73±1.71 mmHg and the dia stolic decreased by 10.83±2.46 mmHg. The changes were statistically significant (P<0.001. There was no correlation between the changes in BP to the changes in IOP. CONCLUSION: IOP decreased in both static and dynamic exercises. There was no correlation between the changes in BP to the changes in IOP

  5. Comparison of IOL--master and ultrasound biometry in preoperative intra ocular lens (IOL) power calculation.

    Science.gov (United States)

    Kolega, Marija Škara; Kovačević, Suzana; Čanović, Samir; Pavičić, Ana Didović; Bašić, Jadranka Katušić

    2015-03-01

    Postoperative refractive outcome largely depends on the accuracy of calculating power of implanted IOL. Lens power calculation can be done by conventional ultrasound biometry and partial coherence laser interferometry (IOL Master). The aim was to compare the accuracy of IOL power calculations using conventional ultrasound biometry and partial coherence laser interferometry.40 eyes were included in this prospective randomized trial. Twenty eyes underwent IOL master and 20 eyes had aplanation ultrasound biometry. There were included only eyes with age-related cataract and postoperative natural visual acuity (VA) 0.7. Visual acuity was performed 6 weeks after cataract surgery. After 6 weeks best natural visual acuity were 0.9 (± 0.1) in IOL-Master group and 0.85 (± 0.15) in ultrasound biometry. The postoperative mean absolute refractive error was 0.75 (± 0.5) D for ultrasound biometry and 0.50 (± 0.50) D for IOL-Master. Optical biometry with the IOL-Master proved to be slightly more accurate than ultrasound biometry for IOL power calculation.

  6. Carbachol as miotic agent in intra-ocular lens implant surgery

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    Agarwal Jitendra

    1988-01-01

    Full Text Available The intra cameral use of 0.025% carbachol as a miotic agent in anterior chamber intraocular lens im-plant surgery us reported in 15 cases. Carbachol produced prompt and effective moisis and was found to be harmless and non-irritating to the anterior chamber structures. A rebound dialatation of the pipit was noticed in the post operative period in 3 of our first 5 cases where only carbachol was used. For prolonged miosis instillation of a more powerful miotic like pilocarpine is recommended at the completion of surgery:

  7. Tratamento conservador em retinoblastoma intra-ocular Conservative treatment for intraocular retinoblastoma

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    Clélia Maria Erwenne

    2003-12-01

    Full Text Available OBJETIVO: Relatar os índices de conservação do globo ocular após tratamento com carboplatina e laser associados ou não a outras formas de tratamento local e radioterapia quando necessário. MÉTODO: Os olhos, virgens de qualquer tratamento, foram inicialmente estadiados, por oftalmoscopia indireta sob narcose ambulatorial, segundo Reese & Ellsworth e os pacientes submetidos à avaliação clínica por pediatra oncologista. Iniciou-se a administração do primeiro ciclo de quimioterapia com carboplatina 200 mg/m², vincristina 1,5 mg/m² e etoposida 150 mg/m² por via endovenosa em 3 dias. Seguiram-se outros ciclos sendo o intervalo entre eles de 21 a 28 dias. De 7 a 15 dias do término do ciclo de quimioterapia, nova oftalmoscopia indireta sob narcose ambulatorial era realizada com descrição dos achados e aplicação de hipertermia por laser Diodo 810 nm, pulso contínuo, e "large spot". O procedimento (quimioterapia e laser foi repetido até completa cicatrização total das lesões ou até que se observasse necessidade de outra modalidade terapêutica como a radioterapia ou a enucleação. Controles periódicos bimensais no primeiro ano e trimestrais nos seguintes foram realizados para reavaliação e tratamento de novas lesões ou recidivas. Acompanhamento clínico por oncologista pediatra foi realizado durante todo o tratamento e seguimento. RESULTADOS: Foram tratados 62 pacientes portadores de RB (32M/30F, 15 unilaterais e 47 bilaterais (total de 107 olhos. A média de idade foi 16,9 meses (2,6 a 71,4. Em 5 pacientes administrou-se 4 ciclos de quimioterapia, nos demais foram necessários mais que 4 e até 8 ciclos. Em 34 olhos não se pode evitar o uso de radioterapia. O tempo médio de seguimento foi de 26,8 meses (5 a 60. Entre os bilaterais os índices de conservação, segundo os estádios de Reese & Ellsworth foram: I 10/11 (90,9%; II 8/9 (88,8%; III 10/10 (100,0%; IV 3/8 (37,5%; V 14/54 (25,9%. Considerando-se o total de bilaterais foram conservados 48,9% dos olhos tratados. Entre os unilaterais, para os mesmos estádios obteve-se: I 0/0; II 2/2 (100,0%; III 1/3 (33,3%; IV 1/3 (33,3%; V 0/7 (0%. Considerando-se o total de unilaterais foram conservados 26,6% dos olhos. Não se observou nefro ou ototoxicidade às drogas neste grupo.PURPOSE: To report the results of conservation of the ocular globe after treatment with carboplatin and laser; with or without the use of other forms of local treatment or radiotherapy, if necessary. METHODS: All eyes, initially untreated, were evaluated using indirect ophthalmology under inhalation anesthesia in an outpatient clinic treatment setting. They were categorized according to the Reese-Ellsworth system; thereafter, the patients were evaluated clinically by a pediatric oncologist. The patients received the first cycle of chemotherapy consisting of intravenous carboplatin 200 mg/m², vincristine 1.5 mg/m² and etoposide 150 mg/m², for three days. This was followed by other cycles with intervals of between 21 and 28 days. From 7 to 15 days after the end of the chemotherapy cycle, another indirect ophthalmoscopy under inhalation anesthesia was performed, with documentation of the findings and laser hyperthermia application, using a Diode laser, 810 nm, continuous pulse with a large spot size. The procedure (chemotherapy and laser was repeated until complete cicatrization of all lesions was observed, or until the need for another treatment modality such as radiotherapy or enucleation became apparent. Follow-up examinations every two months during the first year and three months thereafter were done for review and for treatment of recurrent or new lesions. Pediatric oncology follow-up was also done throughout the entire initial assessment and follow-up period. RESULTS: We treated a total of 62 patients with retinoblastoma, of whom 32 were male and 30 female. Fifteen were unilateral and 47 were bilateral with a total of 107 eyes. The mean age was 16.9 months (2.6 - 71.4. In 5 patients we administered 4 cycles of chemotherapy; but in most cases we found it necessary to use between 4 - 8 chemotherapy cycles. In 34 eyes we could not avoid the use of radiotherapy. The mean follow-up time was 26.8 months (5 - 60. In the bilateral cases, we were able to conserve the globe as follows (Reese & Ellsworth: I 10/11 (90.9%; II 8/9 (88.8%; III 10/10 (100.0%; IV 3/8 (37.5%; V 14/54 (25.9%. Considering all those bilateral cases we reached conservation of 48.9% of the treated eyes. In the unilateral group, we were able to conserve the globe as follows: I 0/0 (0%; II 2/2 (100%; III 1/3 (33.3%; IV 1/3 (33.3%; V 0/0 (0%. Considering the total we conserved 26.6% of the unilateral cases. There was no case of nephrotoxicity or ototoxicity among our patients.

  8. Effect of Ramadan fasting on intra ocular pressure changes in healthy subjects

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    Rahil Karimi Rad

    2017-06-01

    Full Text Available Introduction: Annually, millions of Muslims all over the world observe the fasting rules based on its measures; this highlights the importance of studies in this field as a worthwhile model for intermittent fasting. It is obvious that changes in lifestyle over fasting have outstanding effects on physiological parameters. The current study was carried out to investigate the IOP and serum electrolytes as two important factors that are influenced by human lifestyle. Methods: Eighty-nine fasting and healthy participants including men and women with mean age of 34.97 were included in our study based on the inclusion and exclusion parameters. During this project, Ramadan coincided with the summer (between June and July 2015. All participants were monitored by an expert examiner and blood samples were collected and IOP was measured by tonometer (Topcon, 1-75, Hasunuma-cho, Itabashi-KU, Tokyo, Japan 2014. The participants were examined one week before and one week after Ramadan. Results: There was a significant reduction in physiological IOP in healthy people after Ramadan. In line with this, the serum electrolytes were altered by fasting so that Na, K, Se experienced a significant decrease while serum phosphorous increased (P

  9. Open globe injury with an interesting intra-ocular foreign body

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    Gill, Ekjyot

    2017-07-01

    Full Text Available Introduction: Cases of penetrating ocular trauma due to osseous material are limited, so reported incidents are valuable in determining outcomes and proper treatment courses.Case description: We report a case of an open globe injury of the left eye with an intraocular foreign body occurring after a firework exploded in the hand of a 22-year-old man. The patient presented with light perception vision in the injured eye with a full-thickness limbal laceration and dense hyphema obscuring fundoscopy. CT scan revealed a hyperdense foreign body juxtaposed to the lens. Immediate surgical intervention to repair the globe rupture revealed a defect in the anterior capsule and small, white objects in the posterior chamber that were promptly removed. Pathologic investigation determined these fragments to be cortical bone likely from the patient’s phalanges. Results and discussion: There was no evidence of endophthalmitis or keratitis from time of injury to the five-month follow-up, suggesting that the risk of infection may be low and therefore it may be reasonable to manage these injuries with a period of observation.

  10. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

    2011-11-15

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  11. A Cerebellar Tremor in a Patient with Human Immunodeficiency Virus-1 Associated with Progressive Multifocal Leukoencephalopathy

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    Hee-Jin Kim

    2009-10-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the central nervous system (CNS caused by JC virus infection in oligodendrocytes, especially in patients with acquired immunodeficiency syndrome (AIDS. Movement disorders associated with PML are very rare. Here, we report a case of PML in an AIDS patient who presented with a cerebellar tremor, caused by lesions in the cerebellar outflow tract. A cerebellar tremor can be a rare clinical manifestation in patients with PML.

  12. A Cerebellar Tremor in a Patient with Human Immunodeficiency Virus-1 Associated with Progressive Multifocal Leukoencephalopathy

    Science.gov (United States)

    Kim, Hee-Jin; Lee, Jae-Jung; Lee, Phil Hyu

    2009-01-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by JC virus infection in oligodendrocytes, especially in patients with acquired immunodeficiency syndrome (AIDS). Movement disorders associated with PML are very rare. Here, we report a case of PML in an AIDS patient who presented with a cerebellar tremor, caused by lesions in the cerebellar outflow tract. A cerebellar tremor can be a rare clinical manifestation in patients with PML. PMID:24868366

  13. Progressive multifocal leukoence-phalopathy presenting as homonymous hemianopia in a patient with acquired immunodeficiency syndrome

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    Amit Pandey

    2012-01-01

    Full Text Available We present a case of a Human Immunodeficiency Virus (HIV positive patient who was referred for retinal evaluation to rule out ophthalmic manifestations of Acquired Immunodeficiency Syndrome (AIDS. She complained of some disturbance in vision in both eyes. Fundus examination showed no abnormality. Perimetry, done to rule out optic nerve pathology, showed a left homonymous hemianopia. Magnetic Resonance Imaging (MRI scan showed features of Progressive Multifocal Leukoencephalopathy (PML. She had no other neurological symptoms or signs.

  14. Peripheral refraction with dominant design multifocal contact lenses in young myopes

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    Daniela Lopes-Ferreira

    2013-04-01

    Conclusion: It is possible to induce significant changes in the pattern of relative peripheral refraction in the myopic direction with commercially available dominant design multifocal contact lenses. The higher add (+3.00 D induced an significantly higher effect than the +2.00 D add lens, although an increase of 1 D in add power does not correspond to the same amount of increase in RPRE.

  15. Multifocal electroretinogram for functional evaluation of retinal injury following ischemia-reperfusion in pigs

    DEFF Research Database (Denmark)

    Morén, Håkan; Gesslein, Bodil; Andreasson, Sten

    2010-01-01

    Multifocal electroretinogram (mfERG) has the power to discriminate between localized functional losses and overall retinal changes when evaluating retinal injury. So far, full-field ERG has been the gold standard for examining retinal ischemia and the effects of different neuroprotectants...... in experimental conditions. The aim of the present study was to establish mfERG, with simultaneous fundus monitoring, for analyzing the localized functional response in the retina after ischemia-reperfusion in the porcine eye....

  16. Recurrent multifocal cutaneous Kaposiform hemangioendothelioma: A rare vascular tumor of infancy and childhood

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    Bhagyalakshmi Atla

    2016-01-01

    Full Text Available Kaposiform hemangioendothelioma (KHE is a locally aggressive vascular tumor of childhood although cases occurring in adulthood are also described. The features overlap with juvenile capillary hemangioma and Kaposi sarcoma. We report a rare case of recurrent, multifocal (nose and chin cutaneous KHE initially occurring in a 3-year-old female child, uncomplicated by Kasabach–Merritt syndrome. Recurrences occurred over the next 6 years and resulted in complete distortion of the nose, requiring plastic repair.

  17. Recurrent multifocal cutaneous Kaposiform hemangioendothelioma: A rare vascular tumor of infancy and childhood.

    Science.gov (United States)

    Atla, Bhagyalakshmi; Sudhakar, P V; Rao, Nagarjun; Prasad, Uma

    2016-01-01

    Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor of childhood although cases occurring in adulthood are also described. The features overlap with juvenile capillary hemangioma and Kaposi sarcoma. We report a rare case of recurrent, multifocal (nose and chin) cutaneous KHE initially occurring in a 3-year-old female child, uncomplicated by Kasabach-Merritt syndrome. Recurrences occurred over the next 6 years and resulted in complete distortion of the nose, requiring plastic repair.

  18. Progressive multifocal leukoence--phalopathy presenting as homonymous hemianopia in a patient with acquired immunodeficiency syndrome.

    Science.gov (United States)

    Pandey, Amit; Bandivdekar, Karishma; Ramchandani, Suresh; Ramchandani, Sushama

    2012-01-01

    We present a case of a Human Immunodeficiency Virus (HIV) positive patient who was referred for retinal evaluation to rule out ophthalmic manifestations of Acquired Immunodeficiency Syndrome (AIDS). She complained of some disturbance in vision in both eyes. Fundus examination showed no abnormality. Perimetry, done to rule out optic nerve pathology, showed a left homonymous hemianopia. Magnetic Resonance Imaging (MRI) scan showed features of Progressive Multifocal Leukoencephalopathy (PML). She had no other neurological symptoms or signs.

  19. Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people

    OpenAIRE

    Ellison, Ashton C; Campbell, A John; Robertson, M Clare; Sanderson, Gordon F

    2014-01-01

    Ashton C Ellison, A John Campbell, M Clare Robertson, Gordon F SandersonDunedin School of Medicine, Department of Medicine, Dunedin, New ZealandBackground: Multifocal glasses (bifocals, trifocals, and progressives) increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1) map the prismatic displacement of a progr...

  20. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O'Donovan, Raquel

    2011-01-01

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  1. Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

    International Nuclear Information System (INIS)

    Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu

    2015-01-01

    Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor

  2. Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu [Inha University Hospital, Incheon (Korea, Republic of)

    2015-08-15

    Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor.

  3. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy

    DEFF Research Database (Denmark)

    Segec, A; Keller-Stanislawski, B; Vermeer, N S

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the safe...... use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization....

  4. Multifocal fibrosing thyroiditis: report of 55 cases of a poorly recognized entity.

    Science.gov (United States)

    Fellegara, Giovanni; Rosai, Juan

    2015-03-01

    During the course of our consultation activity, we have recognized a peculiar form of thyroiditis in which multiple foci of fibrosis, most of which were associated with reactive atypia of the surrounding follicles, are present. We have referred to this condition, both in our consultation reports and in the third series of A.F.I.P. Fascicle on Tumors of the Thyroid Gland, as "multifocal fibrosing thyroiditis" or (less frequently) "multifocal sclerosing thyroiditis," which are descriptive terms that highlight the benign/inflammatory nature of the process, its multiplicity, and its unknown pathogenesis. The aim of this study is to better define the morphologic features of this process and correlate it with some clinical data. With this purpose, the consultation files of one of the authors (J.R.) were searched for cases coded as multifocal fibrosing thyroiditis or multifocal sclerosing thyroiditis in a 20-year period ranging from January 1989 to December 2009. A total of 55 cases were identified that displayed the above-listed features. There were 51 (93%) female and 4 (7%) male patients (F/M=12.75), with ages ranging between 15 and 71 years (mean age, 47.03 y; median age, 44.5 y). Microscopically, multiple foci of fibrosis were identified in all cases, their number ranging from 2 to 51 per case (mean number, 16), with a mean diameter of 3 mm (range: 0.36 to 15.1 mm). Although heterogenous in shape and size, the individual foci were rather similar to each other in composition, being characterized by a fibrotic poorly cellular center that merged with a cellular peripheral zone. Some of the follicular structures present at the periphery of the scar and-to a lesser extent-those entrapped inside it underwent complex reactive and regenerative (atypical) changes that simulated malignancy. We discuss the differential diagnosis with other benign and malignant thyroid conditions and speculate about its pathogenesis and possible relationship with papillary thyroid microcarcinoma.

  5. Determining the origin of synchronous multifocal bladder cancer by exome sequencing

    International Nuclear Information System (INIS)

    Acar, Ömer; Özkurt, Ezgi; Demir, Gulfem; Saraç, Hilal; Alkan, Can; Esen, Tarık; Somel, Mehmet; Lack, Nathan A.

    2015-01-01

    Synchronous multifocal tumours are commonly observed in urothelial carcinomas of the bladder. The origin of these physically independent tumours has been proposed to occur by either intraluminal migration (clonal) or spontaneous transformation of multiple cells by carcinogens (field effect). It is unclear which model is correct, with several studies supporting both hypotheses. A potential cause of this uncertainty may be the small number of genetic mutations previously used to quantify the relationship between these tumours. To better understand the genetic lineage of these tumours we conducted exome sequencing of synchronous multifocal pTa urothelial bladder cancers at a high depth, using multiple samples from three patients. Phylogenetic analysis of high confidence single nucleotide variants (SNV) demonstrated that the sequenced multifocal bladder cancers arose from a clonal origin in all three patients (bootstrap value 100 %). Interestingly, in two patients the most common type of tumour-associated SNVs were cytosine mutations of TpC* dinucleotides (Fisher’s exact test p < 10 −41 ), likely caused by APOBEC-mediated deamination. Incorporating these results into our clonal model, we found that TpC* type mutations occurred 2-5× more often among SNVs on the ancestral branches than in the more recent private branches (p < 10 −4 ) suggesting that TpC* mutations largely occurred early in the development of the tumour. These results demonstrate that synchronous multifocal bladder cancers frequently arise from a clonal origin. Our data also suggests that APOBEC-mediated mutations occur early in the development of the tumour and may be a driver of tumourigenesis in non-muscle invasive urothelial bladder cancer. The online version of this article (doi:10.1186/s12885-015-1859-8) contains supplementary material, which is available to authorized users

  6. [Clinical results after implantation of a new segmental refractive multifocal intraocular lens].

    Science.gov (United States)

    Thomas, B C; Auffarth, G U; Philips, R; Novák, J; Blazek, J; Adamkova, H; Rabsilber, T M

    2013-11-01

    The aim of the study was a clinical evaluation of an intraocular lens (IOL) with a segmental multifocal optic design and near addition of + 3.0 D as part of a CE approval study. In a multicenter study the LENTIS Mplus LS-312 MF IOL (Oculentis) was implanted in 134 eyes of 79 patients with a mean age of 68 ± 12 years. The multifocality is achieved by implementation of a distance part and a segmented near sector. Three months after surgery, uncorrected and best corrected distance visual acuity (UCDVA and BCDVA, respectively), near visual acuity (UCNVA and BCNVA, respectively), contrast vision and patient satisfaction (questionnaire) were evaluated. The IOLs were implanted uneventfully either unilaterally or bilaterally and 3 months postoperatively (n = 86 eyes) the following mean visual acuities were obtained (logMAR): UCDVA = 0.05, BCDVA = - 0.01, UCNVA = 0.09 and BCNVA = 0.02. Contrast sensitivity (n = 25 eyes) was within normal limits. Of the 66 questioned patients 10.6% spontaneously reported halos and 3% glare. This new innovative multifocal IOL concept showed very good functional results as well as high patient satisfaction.

  7. Influence of Near-Segment Positioning in a Rotationally Asymmetric Multifocal Intraocular Lens.

    Science.gov (United States)

    Song, In Seok; Yoon, Sam Young; Kim, Jae Yong; Kim, Myoung Joon; Tchah, Hungwon

    2016-04-01

    To compare visual performance and higher order aberrations (HOAs) based on the position of the near segment in eyes with rotationally asymmetric multifocal intraocular lenses (IOLs). Asymmetric multifocal IOLs (Lentis Mplus LS-313; Oculentis Optikgeräte GmbH, Wetzlar, Germany) were implanted with the near segment positioned either inferiorly, superiorly, or temporally. Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, corrected distance visual acuity (CDVA), and distance-corrected intermediate (DCIVA) and near (DCNVA) visual acuity, contrast sensitivity, HOAs, and subjective symptom questionnaires were compared at 1 month postoperatively. Forty-five eyes from 45 patients were evaluated (n = 25, 9, and 11 eyes in the inferior, superior, and temporal groups, respectively). No significant differences in UDVA, UIVA, UNVA, CDVA, DCIVA, or DCNVA were found between the three groups (P > .05). The temporal group showed the best results in UDVA, CDVA, and DCNVA, but the inferior group showed the best results in DCIVA and UNVA and the superior group showed the best results in UIVA. Contrast sensitivity and the subjective symptom questionnaire also did not demonstrate any significant differences (P > .05). Total HOA and spherical aberration did not demonstrate any statistically significant differences (P > .05), but vertical coma and horizontal coma demonstrated significant differences based on near segment position (P < .001). The position of the near segment in eyes with rotationally asymmetric multifocal IOLs demonstrates no significant effect on visual performance. Copyright 2016, SLACK Incorporated.

  8. Validity of automated refraction after segmented refractive multifocal intraocular lens implantation.

    Science.gov (United States)

    Albarrán-Diego, César; Muñoz, Gonzalo; Rohrweck, Stephanie; García-Lázaro, Santiago; Albero, José Ricardo

    2017-01-01

    To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D) for sphere. Astigmatism showed better correlation between KR and MR. We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected.

  9. Multifocal Intraocular Lens Results in Correcting Presbyopia in Eyes After Radial Keratotomy.

    Science.gov (United States)

    Kim, Kyeong Hwan; Seok, Kyung-Won; Kim, Wan Soo

    2017-11-01

    To report results of multifocal intraocular lens (IOL) implantation in 2 patients with refractive error and presbyopia after previous radial keratotomy (RK). A refractive multifocal IOL with rotational asymmetry (LS313-MF30; Oculentis, Berlin, Germany) was implanted. The first patient was a 60-year-old man with myopia who underwent unilateral RK 20 years before. His uncorrected distance visual acuity (UDVA) was 20/400, and his distance corrected near vision was J9 in both eyes. Six months after bilateral surgery, his binocular UDVA and uncorrected near visual acuity (UNVA) improved to 20/20 and J1, respectively, although he experienced diurnal fluctuation. The second patient was a 55-year-old woman with hyperopia who underwent bilateral RK 18 years before. Uncorrected distance visual acuity was 20/25 in both eyes, but UNVA was between J9 and J10. Three months after unilateral surgery, UDVA and UNVA of the postsurgical eye improved to 20/20 and J1, respectively. Neither patient reported any significant photic phenomena, and both were satisfied with the results of treatment. The desirable clinical outcomes and levels of satisfaction expressed by these patients indicate that surgery using this particular multifocal IOL may benefit presbyopic patients with previous RK.

  10. Validity of automated refraction after segmented refractive multifocal intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    César Albarrán-Diego

    2017-11-01

    Full Text Available AIM: To evaluate the clinical utility of automated refraction (AR and keratometry (KR compared with subjective or manifest refraction (MR after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH refractive multifocal intraocular lens (IOL. METHODS: Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. RESULTS: Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D for sphere. Astigmatism showed better correlation between KR and MR. CONCLUSION: We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected.

  11. Multifocal Langerhans cell sarcoma involving epidermis: a case report and review

    Directory of Open Access Journals (Sweden)

    Wang Changsong

    2012-08-01

    Full Text Available Abstract Objective To study the clinico-pathological characteristics of Langerhans cell sarcoma (LCS which involving epidermis. Methods A case of primary multifocal LCS was analyzed in histopathology and immunophenotype. Results A 41-year-old man with multifocal cutaneous LCS involving the inguina and waist was reported. Clinical and pathology data were available. Neoplastic cells with markedly malignant cytological features were observed. Tumor cells exhibited irregular shape with abundant and eosinophilic red staining cytoplasm; large, irregular-shaped, showing lobulated or dented nucleus and some cells with a longitudinal nuclear groove and prominent nucleoli. The tumor cells expressed CD1a, Langerin (CD207, S-100 protein, CD68 and vimentin, and did not express pan-T or B cell markers and epithelial markers. The patient died less than 1 year after diagnosis due to local recurrence and metastasis to the lung, despite the administration of local radiation and chemotherapy. Conclusions LCS is a tumor with markedly malignant cytological features that originates from Langerhans cells. Primary multifocal neoplasms involving epidermis is even rare. Accurate diagnosis is based on the histopathological and immunohistochemical of the tumor cells. Virtual slide The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1182345104754765.

  12. N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Lobna Ouldamer

    Full Text Available The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality.Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality.We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality.These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

  13. Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive multifocal lenses and monovision

    Directory of Open Access Journals (Sweden)

    Stock RA

    2017-07-01

    Full Text Available Ricardo Alexandre Stock, Thaís Thumé, Luan Gabriel Paese, Elcio Luiz Bonamigo Universidade do Oeste de Santa Catarina, Rua Getúlio Vargas, Joaçaba, Santa Catarina, Brazil Purpose: To analyze patient satisfaction and difficulties with bilateral multifocal intraocular lenses (IOLs implantation and aspheric monofocal IOLs implantation using monovision, after cataract surgery.Materials and methods: A total of 61 participants were included in the study, 29 with monovision and 32 with multifocal lenses. The inclusion criteria were patients undergoing phacoemulsification for bilateral visual impairment due to cataracts and presenting with postoperative visual acuity of 20/30 or better for distance and line J3 or better for near vision.Results: The 2 groups had similar results regarding difficulties with daily activities such as distance vision, near vision, watching television, reading, cooking, using a computer or cellphone, shaving/putting on makeup and shopping. There were differences in responses between the groups regarding difficulty with night vision (P=0.0565 and night driving (P=0.0291. Degree of satisfaction in terms of distance vision without glasses was statistically significantly better in monovision group (P=0.0332, but not for near (P=0.9101.Conclusion: Both techniques yielded satisfactory results regarding visual acuity for different activities without the need to use glasses. Multifocal lenses are a good option for patients with the exception of night driving, and who desire independence from glasses. Keywords: cataract extraction, aphakia, postcataract, patient satisfaction, night vision

  14. Conservative treatment of soft tissue sarcomas of the extremities. Functional evaluation with LENT-SOMA scales and the Enneking score; Traitement conservateur des sarcomes des tissus mous des membres. Evaluation du resultat fonctionnel selon l'echelle LENT-SOMA et le score de Enneking

    Energy Technology Data Exchange (ETDEWEB)

    Tawfiq, N.; Lagarde, P.; Thomas, L.; Kantor, G. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, Service de Radiotherapie, 33 - Bordeaux (France); Stockle, E. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, Service de Chirurgie, 33 - Bordeaux (France); Bui, B.N. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, Service d' Oncologie Medicale, 33 - Bordeaux (France)

    2000-12-01

    Objective. - The aim of this prospective study is the feasibility of late effects assessment by LENT-SOMA scales after conservative treatment of soft tissue sarcomas of the extremities and a comparison with the functional evaluation by the Enneking score. Patients and methods. - During the systematic follow-up consultations, a series of 32 consecutive patients was evaluated in terms of late effects by LENT SOMA scales and functional results by the Enneking score. The median time after treatment was 65 months. The treatment consisted of conservative surgery (all cases) followed by radiation therapy (29 cases), often combined with adjuvant therapy (12 concomitant radio-chemotherapy association cases out of 14). The assessment of the toxicity was retrospective for acute effects and prospective for the following late tissue damage: skin/subcutaneous tissues, muscles/soft tissues and peripheral nerves. Results. -According to the Enneking score, the global score for the overall series was high (24/30) despite four the scores zero for the psychological acceptance. According to LENT SOMA scales, a low rate of severe sequelae (grade 3-4) was observed. The occurrence of high-grade sequelae and their functional consequences were not correlated with quality of exeresis, dose of radiotherapy or use of concomitant chemotherapy. A complementarity was observed between certain factors of the Enneking score and some criteria of the LENTSOMA scales, especially of muscles/soft tissues. Conclusion. -The good quality of functional results was confirmed by the two mean scoring systems for late normal tissue damage. The routine use of LENT-SOMA seems to be more time consuming than the Enneking score (mean time of scoring: 1 3 versus five minutes). The LENT-SOMA scales are aimed at a detailed description of late toxicity and sequelae while the Enneking score provides a more global evaluation, including the psychological acceptance of treatment. The late effects assessment by the LENT

  15. Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Schallhorn SC

    2016-04-01

    Full Text Available Steven C Schallhorn,1–3 Jan A Venter,2 David Teenan,2 Julie M Schallhorn,3 Keith A Hettinger,2 Stephen J Hannan,2 Martina Pelouskova2 1Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Optical Express, Glasgow, UK; 3Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA Purpose: The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC to correct residual refraction after multifocal intraocular lens (IOL implantation. Patients and methods: In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results: The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution] and after LVC procedure (-0.04±0.07 logMAR; P=0.70. There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion: LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of

  16. Long-term radiation sequelae after breast-conserving therapy in women with early-stage breast cancer: an observational study using the LENT-SOMA scoring system

    International Nuclear Information System (INIS)

    Fehlauer, Fabian; Tribius, Silke; Hoeller, Ulrike; Rades, Dirk; Kuhlmey, Antje; Bajrovic, Amira; Alberti, Winfried

    2003-01-01

    Purpose: To evaluate the long-term toxicity after breast-conserving therapy in women with early-stage breast cancer. Methods and Materials: Late toxicity according to the late effects of normal tissue-subjective, objective, management, and analytic (LENT-SOMA) criteria and cosmetic outcome (graded by physicians) were evaluated in 590 of 2943 women with early-stage breast cancer who were irradiated between 1983 and 1995 using the following fractionation schedules: group A, 1983-1987, 2.5 Gy 4x/wk to 60 Gy; group B, 1988-1993, 2.5 Gy 4x/wk to 55 Gy, group C, 1994-1995, 2.0 Gy 5x/wk to 55 Gy. Results: LENT-SOMA Grade 3-4 toxicity was observed as follows: group A (median follow-up 171 months; range 154-222 months), fibrosis 16% (7 of 45), telangiectasia 18% (8 of 45), and atrophy 4% (2 of 45); group B (median follow-up 113 months; range 78-164 months), pain 2% (8 of 345), fibrosis 10% (34 of 345), telangiectasia 10% (33 of 345), arm edema 1% (2 of 345), and atrophy 8% (27 of 345); and group C (median follow-up 75 months, range 51-96 months, n = 200), occurrence of Grade 3-4 late morbidity ≤2%. The cosmetic outcome was very good to acceptable in 78% (35 of 45) of patients in group A, 83% (286 of 345) in group B, and 94% (187 of 200) in group C. Conclusion: In our population, the long-term side effects after breast-conserving therapy were not rare, but were mainly asymptomatic. The LENT-SOMA breast module is a practical tool to assess radiation-induced long-term toxicity

  17. Lente fácica de câmara posterior para correção de hipermetropia consecutiva à ceratotomia radial

    Directory of Open Access Journals (Sweden)

    Salera Cristina Moreira

    2003-01-01

    Full Text Available OBJETIVO: Avaliar a eficácia, previsibilidade e segurança do implante de lente fácica de câmara posterior para a correção de hipermetropia consecutiva à ceratotomia radial. MÉTODOS: Foram analisados retrospectivamente os prontuários de seis pacientes (10 olhos com hipermetropia consecutiva à hipercorreção após ceratotomia radial submetidos ao implante de lente fácica de câmara posterior para sua correção. RESULTADOS: O equivalente esférico pré-operatório médio da refração dinâmica foi de +4,65 dioptrias (variando de +2,50 a +6,50 dioptrias e o equivalente esférico pós-operatório médio foi de +0,3375 dioptrias (variando de -0,875 a +2,25 dioptrias. Quando comparamos as acuidades visuais com correção pré e pós-operatórias observamos que três olhos (30% ganharam duas linhas de acuidade visual, dois (20% ganharam uma linha de acuidade visual, um (10% manteve a mesma acuidade visual, três olhos (30% perderam uma linha de acuidade visual e um olho (10% perdeu duas linhas. CONCLUSÃO: O implante da lente fácica de câmara posterior para correção da hipermetropia consecutiva à ceratotomia radial mostrou-se como uma nova opção para o tratamento desta indesejável complicação, entretanto, fazem-se necessários estudos abrangendo maior número de casos e um acompanhamento a longo prazo destes casos.

  18. Mensurações do bulbo ocular e cálculo do poder dióptrico de lentes intraoculares em coelhos

    Directory of Open Access Journals (Sweden)

    M.A.R. Valinhos

    2012-02-01

    Full Text Available Determinaram-se as dimensões oculares de coelhos, empregando ultrassonografia modo-A e ceratometria, a fim de utilizá-las como subsídios para calcular o poder dióptrico de lentes intraoculares a serem implantadas experimentalmente nessa espécie e avaliar se existe diferença entre as mensurações oculares de machos e fêmeas e entre olho esquerdo e olho direito. Foram utilizados 58 animais do grupo genético Botucatu, distribuídos entre 30 fêmeas e 28 machos, com idade média de 85,8±8,29 dias e peso médio de 2,3±0,46kg. O cálculo da lente intraocular foi realizado por meio do software Holladay IOL Consultant®. As fórmulas empregadas para o cálculo foram: Holladay II, Holladay I, Hoffer Q e SRK-T, que calcularam lentes de aproximadamente 48,5 D; 50,27 D; 59,67 D e 49,24 D, respectivamente. A fórmula SRK-T mostrou-se semelhante às fórmulas Holladay II e Holladay I, enquanto entre as demais ocorreram diferenças. As características biométricas oculares avaliadas, assim como o poder dióptrico calculado por uma mesma fórmula, não apresentaram diferenças significativas com relação ao sexo e à lateralidade.

  19. Elaboración y gestión de un programa de mantenimiento para una fábrica de lentes oftálmicos

    OpenAIRE

    Garrafa Ayquipa, Henry Calixto; Garrafa Ayquipa, Henry Calixto

    2007-01-01

    La fabricación de lentes oftálmicos es una industria de poco desarrollo en el Perú. Sin embargo, Topsa se ha preocupado por ser una empresa competitiva, realizando inversiones en tecnología y mejora de sus procesos, convirtiéndola en una empresa lideren la industria. En la última década, las ventas de Topsa crecieron a razón del 20 % anual, por ello se amplió la capacidad de planta adquiriendo nuevas maquinarias. También, se incrementaron los reclamos de los clientes por productos defec...

  20. Case report: multifocal subchondral stress fractures of the femoral heads and tibial condyles in a young military recruit.

    Science.gov (United States)

    Yoon, Pil Whan; Yoo, Jeong Joon; Yoon, Kang Sup; Kim, Hee Joong

    2012-03-01

    Subchondral stress fractures of the femoral head may be either of the insufficiency-type with poor quality bone or the fatigue-type with normal quality bone but subject to high repetitive stresses. Unlike osteonecrosis, multiple site involvement rarely has been reported for subchondral stress fractures. We describe a case of multifocal subchondral stress fractures involving femoral heads and medial tibial condyles bilaterally within 2 weeks. A 27-year-old military recruit began having left knee pain after 2 weeks of basic training, without any injury. Subsequently, right knee, right hip, and left hip pain developed sequentially within 2 weeks. The diagnosis of multifocal subchondral stress fracture was confirmed by plain radiographs and MR images. Nonoperative treatment of the subchondral stress fractures of both medial tibial condyles and the left uncollapsed femoral head resulted in resolution of symptoms. The collapsed right femoral head was treated with a fibular strut allograft to restore congruity and healed without further collapse. There has been one case report in which an insufficiency-type subchondral stress fracture of the femoral head and medial femoral condyle occurred within a 2-year interval. Because the incidence of bilateral subchondral stress fractures of the femoral head is low and multifocal involvement has not been reported, multifocal subchondral stress fractures can be confused with multifocal osteonecrosis. Our case shows that subchondral stress fractures can occur in multiple sites almost simultaneously.

  1. Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional Form of Bietti′s Crystalline Retinopathy

    Institute of Scientific and Technical Information of China (English)

    Libin Jiang; Feng Wen; Lezheng Wu; Hong Yan; Shixing Hu

    2002-01-01

    Prpose: To observe different features of indocyanine green angiography(ICGA) andtifocal electroretinography (ERG) in the diffuse and regional type of Bieti′sc stalline retinopathy (BCR). Thods: ICGA and the multifocal ERG were performed in two cases of the diffuse andregional type of BCR respectively. These data were compared with fluoresceinangiography (FA), standard Ganzfeld ERG, and visual field testing. Results: In the regional case, ICGA revealed reduced perfusion of the choroidalcirculation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase, due to choriocapillaris filling defect; the extent of choroiocapillaris losswas shown in early phase of ICGA and there were multifocal hyperfluorescent dotssurrounding hypofluorescent spots in late phase in the diffuse case. The multifocal ERGshowed that the central responses were markedly depressed, corresponding to the visualfield defects, while the findings of Ganzfeld ERG were normal in the regional BCR;however, both the multifocal ERG and Ganzfeld ERG were severely subnormal in thediffuse case.Conclusions: The features of ICGA and multifocal ERG are different between the diffuseand regional BCR. In the meantime, the two tools are also useful to differentiate the typeand assess the extentof evolution in BCR.

  2. Acanthamoeba sp.: un caso de queratitis no relacionada con el uso de lentes de contacto Acanthamoeba sp.: a case report in a non-contact lens wearer

    Directory of Open Access Journals (Sweden)

    Claudia Menghi

    2012-12-01

    Full Text Available La queratitis por Acanthamoeba sp. generalmente se relaciona con el uso de lentes de contacto y en menor proporción se vincula con el contacto con agua contaminada. Se caracteriza por una disminución de la capacidad visual y la presencia de un fuerte dolor ocular. al examen clínico, puede confundirse con una infección herpética. Si la infección no es diagnosticada y tratada a tiempo en forma adecuada, puede culminar en la perforación de la córnea y, eventualmente, en la pérdida del ojo. en este trabajo se informa uno de los pocos casos registrados de queratitis por Acanthamoeba sp. no relacionada con el uso de lentes de contacto.Acanthamoeba sp. keratitis is generally related to wearing contact lenses, and, to a lesser extent, to contaminated water. it is characterized by reduced visual capacity and the presence of severe ocular pain. Clinically, it can be mistaken for a herpes infection. if it is not diagnosed, and timely and adequately treated, it can result in corneal perforation and, eventually, in vision loss. One of the few registered cases of Acanthamoeba sp. keratitis not related to the use of contact lenses is herein reported.

  3. Multifocal demyelinating motor neuropathy and hamartoma syndrome associated with a de novo PTEN mutation.

    Science.gov (United States)

    Bansagi, Boglarka; Phan, Vietxuan; Baker, Mark R; O'Sullivan, Julia; Jennings, Matthew J; Whittaker, Roger G; Müller, Juliane S; Duff, Jennifer; Griffin, Helen; Miller, James A L; Gorman, Grainne S; Lochmüller, Hanns; Chinnery, Patrick F; Roos, Andreas; Swan, Laura E; Horvath, Rita

    2018-05-22

    To describe a patient with a multifocal demyelinating motor neuropathy with onset in childhood and a mutation in phosphatase and tensin homolog ( PTEN ), a tumor suppressor gene associated with inherited tumor susceptibility conditions, macrocephaly, autism, ataxia, tremor, and epilepsy. Functional implications of this protein have been investigated in Parkinson and Alzheimer diseases. We performed whole-exome sequencing in the patient's genomic DNA validated by Sanger sequencing. Immunoblotting, in vitro enzymatic assay, and label-free shotgun proteomic profiling were performed in the patient's fibroblasts. The predominant clinical presentation of the patient was a childhood onset, asymmetric progressive multifocal motor neuropathy. In addition, he presented with macrocephaly, autism spectrum disorder, and skin hamartomas, considered as clinical criteria for PTEN-related hamartoma tumor syndrome. Extensive tumor screening did not detect any malignancies. We detected a novel de novo heterozygous c.269T>C, p.(Phe90Ser) PTEN variant, which was absent in both parents. The pathogenicity of the variant is supported by altered expression of several PTEN-associated proteins involved in tumorigenesis. Moreover, fibroblasts showed a defect in catalytic activity of PTEN against the secondary substrate, phosphatidylinositol 3,4-trisphosphate. In support of our findings, focal hypermyelination leading to peripheral neuropathy has been reported in PTEN-deficient mice. We describe a novel phenotype, PTEN-associated multifocal demyelinating motor neuropathy with a skin hamartoma syndrome. A similar mechanism may potentially underlie other forms of Charcot-Marie-Tooth disease with involvement of the phosphatidylinositol pathway. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  4. Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens.

    Science.gov (United States)

    van der Linden, Jan Willem; Vrijman, Violette; Al-Saady, Rana; El-Saady, Rana; van der Meulen, Ivanka J; Mourits, Maarten P; Lapid-Gortzak, Ruth

    2014-12-01

    To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312 MF30, Oculentis, Germany). At 3 months postoperatively, the AR and MR values were compared to determine the correlation between the sphere (S), the spherical equivalent (SE) and the astigmatic components J0 and J45. The difference of mean spherical measurement was +0.98D ± 0.62, with the AR measuring more myopic. The difference of the mean spherical equivalent was +1.11D ± 0.57, again with AR being more myopic. Both these differences were statistically significant (p < 0.001). The astigmatic components showed less differences, with the mean difference of the J0 being -0.09D ± 0.43, and the J45 of +0.04D ± 0.47, which were both not statistically significant (p = 0.123 and p = 0.531, respectively). Correlation analysis of the refractive parameters showed r(2) = 0.067, r(2) = 0.078, r(2) = 0.018 and r(2) = 0.015, respectively, all of which point to a low correlation between the AR and the MR. Autorefraction shows poor correlation to manifest subjective refraction with these radially asymmetric multifocal IOLs. The autorefraction systematically underestimates the spherical and spherical equivalent power, while the correlation between the astigmatic components was also low. Autorefraction seems not a valid starting point for manifest subjective refraction with these types of lenses, unless a corrective factor of about +1 dioptre is used. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Pushpender, E-mail: pugupta@wakehealth.edu; Allen, Brian C., E-mail: bcallen2@wakehealth.edu; Chen, Michael Y., E-mail: mchen@wakehealth.edu; Childs, David D., E-mail: dchilds@wakehealth.edu; Kota, Gopi, E-mail: gkota@wakehealth.edu; Zagoria, Ronald J., E-mail: rzagoria@wakehealth.edu [Wake Forest University School of Medicine, Department of Radiology (United States)

    2013-10-15

    Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37-88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2-3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function.

  6. Imaging of chronic recurrent multifocal osteomyelitis of childhood first presenting with isolated primary spinal involvement

    International Nuclear Information System (INIS)

    Anderson, S.E.; Heini, P.; Kalbermatten, D.; Sauvain, M.J.; Stauffer, E.; Geiger, L.; Johnston, J.O.; Roggo, A.; Steinbach, L.S.

    2003-01-01

    Initial presentation with primary spinal involvement in chronic recurrent multifocal osteomyelitis of childhood (CRMO) is rare. Our objective was to review the imaging appearances of three patients who had CRMO who initially presented with isolated primary spinal involvement.Design and patients The imaging, clinical, laboratory and histology findings of the three patients were retrospectively reviewed. Imaging included seven spinal MR imaging scans, one computed tomography scan, nine bone scans, two tomograms and 16 radiographs. These were reviewed by two musculoskeletal radiologists and a consensus view is reported. All three patients presented with atraumatic spinal pain and had extensive bone spinal pathology. The patients were aged 11, 13 and 12 years. There were two females and one male.Results and conclusions The initial patient had thoracic T6 and T8 vertebra plana. Bone scan showed additional vertebral body involvement. Follow-up was available over a 3 year period. The second patient had partial collapse of T9 and, 2 years later, of C6. Subsequently extensive multifocal disease ensued and follow-up was available over 8 years. The third patient initially had L3 inferior partial collapse and 1 year later T8 involvement with multifocal disease. Follow-up was available over 3 years. The imaging findings of the three patients include partial and complete vertebra plana with a subchondral line adjacent to endplates associated with bone marrow MR signal alterations. Awareness of the imaging appearances may help the radiologist to include this entity in the differential diagnosis in children who present with spinal pathology and no history of trauma. Histopathological examination excludes tumor and infection but with typical imaging findings may not always be necessary. (orig.)

  7. Noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine: A case report

    Directory of Open Access Journals (Sweden)

    Rong Wang

    2017-06-01

    Full Text Available Brucellosis is a zoonosis infectious disease, brucellar spondylitis primarily infects the lumbar, the cervical is uncommon. Multiple-level involvement is extremely rare. This report describes a 46-year-old man with noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine. Brucellar spondylitis is difficult to diagnose. Routine laboratory findings for the disease have little diagnostic value. Manifestations and radiological features are usually nonspecific. Radiological features of brucellar spondylitis are similar to tuberculous spondylitis and pyogenic spondylitis. MRI findings have diagnostic value. Suspicious patients with unexplained fever, musculoskeletal complaints at risk of infection should be considered.

  8. Mefloquine improved progressive multifocal leukoencephalopathy in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Beppu, Minako; Kawamoto, Michi; Nukuzuma, Souichi; Kohara, Nobuo

    2012-01-01

    We describe a case of a 67-year-old man with systemic lupus erythematosus who presented with progressive left hemiplegia. Although the cerebral spinal fluid (CSF) polymerase chain reaction (PCR) for the JC virus was negative, a brain biopsy confirmed the diagnosis of progressive multifocal leukoencephalopathy (PML). The tapering of prednisone and the use of cidofovir could not arrest the disease progression. Administration of mefloquine stopped the extension of the lesion, and resulted in obvious clinical improvement. The CSF nested PCR for the JC virus also became negative. This widely used drug should be tried for the treatment of non-HIV PML.

  9. High Resolution Depth-Resolved Imaging From Multi-Focal Images for Medical Ultrasound

    DEFF Research Database (Denmark)

    Diamantis, Konstantinos; Dalgarno, Paul A.; Greenaway, Alan H.

    2015-01-01

    An ultrasound imaging technique providing subdiffraction limit axial resolution for point sources is proposed. It is based on simultaneously acquired multi-focal images of the same object, and on the image metric of sharpness. The sharpness is extracted by image data and presents higher values...... calibration curves combined with the use of a maximum-likelihood algorithm is then able to estimate, with high precision, the depth location of any emitter fron each single image. Estimated values are compared with the ground truth demonstrating that an accuracy of 28.6 µm (0.13λ) is achieved for a 4 mm depth...

  10. A case of natalizumab-associated progressive multifocal leukoencephalopathy with repeated negative CSF JCV testing.

    Science.gov (United States)

    Mazda, Monica E; Brosch, Jared R; Wiens, Andrea L; Bonnin, José M; Kamer, Aaron P; Mattson, David H; Snook, Riley J

    2013-05-01

    The development of progressive multifocal leukoencephalopathy (PML) in patients treated with natalizumab is a well-known potential risk. Diagnosis of PML can be confounded in patients with multiple sclerosis (MS) if new demyelinating lesions develop, and the sensitivity of existing diagnostic tests is less than ideal. In the case presented here, four samples of cerebrospinal fluid tested negative for John Cunningham virus (JCV) DNA by polymerase chain reaction, yet brain biopsy eventually proved positive by immunohistochemistry. A review of the limitations of existing clinical diagnostic tests is addressed, and we review the most recent literature on the proper management of natalizumab-treated MS patients.

  11. Progressive multifocal leucoencephalopathy in a patient with idiopathic CD4+ lymphocytopenia.

    LENUS (Irish Health Repository)

    Moloney, F

    2012-03-01

    Progressive multifocal leucoencephalopathy (PML) is an opportunistic, demyelinating neurological disease caused by reactivation of the JC polyomavirus. PML occurs almost exclusively in immunosuppressed individuals, with only isolated case reports of PML occurring in patients without apparent immunosuppression. Idiopathic CD4+ lymohocytopenia (ICL) is a syndrome defined by the Centre for Disease Control and Prevention as a CD4+ count <300 cells\\/uL or <20% of total T cell count on >1 occasion, with no evidence of human immunodeficiency virus (HIV) infection, and the absence of other known immunodeficiency or therapy associated with lymphocytopenia. We describe a case of PML occurring in a patient with idiopathic CD4+ lymphocytopenia.

  12. Multifocal, recurrent malignant chondroid syringoma with visceral metastases: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Ann Meredith Garcia

    2016-03-01

    Full Text Available We present the unusual case of malignant chondroid syringoma (MCS in a 64-year-old male with recurrent nodular skin lesions and visceral metastases. The patient underwent repeated excisions, with eventual development of widespread nodules and multiple pulmonary and hepatic nodules. Systemic chemotherapy was planned. MCS is a very rare skin adnexal tumor of the sweat glands with only around 50 cases reported worldwide. To the authors’ knowledge, this is the first reported case of MCS with a multifocal presentation and mucosal involvement.

  13. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy.

    Science.gov (United States)

    Segec, A; Keller-Stanislawski, B; Vermeer, N S; Macchiarulo, C; Straus, S M; Hidalgo-Simon, A; De Bruin, M L

    2015-11-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the safe use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization. © 2015 American Society for Clinical Pharmacology and Therapeutics.

  14. Carcinoma superficial multifocal do pênis: ênfase ao teste do azul de toluidina

    Directory of Open Access Journals (Sweden)

    Hélio Begliomini

    Full Text Available The author reports a case of penile multifocal superficial carcinoma in a white 66 years old male. The lesions on glans penis and prepuce were asymptomatic. Their appearence were plain reddish ulceration, irregular margins which became evident after circumcision. There was no palpable groin lymph node. The toluidine blue test was useful for guiding biopsies. A partial penectomy was undertaken with free surgical margins of tumor. In a follow-up of two years, penil erectile function is preserve with no tumor recurrence.

  15. Correção do astigmatismo irregular com lente intraocular tórica em um paciente com catarata e degeneração marginal pelúcida: relato de caso

    Directory of Open Access Journals (Sweden)

    Ana Luiza Biancardi

    2012-12-01

    Full Text Available A degeneração marginal pelúcida (DMP é uma rara ectasia corneana cuja progressão resulta em astigmatismo irregular e baixa visual não corrigidos com óculos ou lentes de contato. O presente relato descreve um paciente com catarata e DMP que foi tratado com facoemulsificação e implante de lente intraocular tórica com recuperação da acuidade visual em ambos os olhos.

  16. Optical design of soft multifocal contact lens with uniform optical power in center-distance zone with optimized NURBS.

    Science.gov (United States)

    Vu, Lien T; Chen, Chao-Chang A; Yu, Chia-Wei

    2018-02-05

    This study aims to develop a new optical design method of soft multifocal contact lens (CLs) to obtain uniform optical power in large center-distance zone with optimized Non-Uniform Rational B-spline (NURBS). For the anterior surface profiles of CLs, the NURBS design curves are optimized to match given optical power distributions. Then, the NURBS in the center-distance zones are fitted in the corresponding spherical/aspheric curves for both data points and their centers of curvature to achieve the uniform power. Four cases of soft CLs have been manufactured by casting in shell molds by injection molding and then measured to verify the design specifications. Results of power profiles of these CLs are concord with the given clinical requirements of uniform powers in larger center-distance zone. The developed optical design method has been verified for multifocal CLs design and can be further applied for production of soft multifocal CLs.

  17. Clinical and patient-reported outcomes of bilateral implantation of a +2.5 diopter multifocal intraocular lens.

    Science.gov (United States)

    Maxwell, Andrew; Holland, Edward; Cibik, Lisa; Fakadej, Anna; Foster, Gary; Grosinger, Les; Moyes, Andrew; Nielsen, Stephen; Silverstein, Steven; Toyos, Melissa; Weinstein, Arthur; Hartzell, Scott

    2017-01-01

    To assess the effectiveness and safety of a multifocal intraocular lens (IOL) with +2.5 diopter (D) additional power compared with a monofocal IOL. Fifteen sites in the United States. Prospective randomized patient- and observer-masked clinical trial. Randomized patients received multifocal or monofocal IOLs bilaterally. Visual acuity (33 cm, 40 cm, 53 cm, 60 cm, 4 m) was measured; safety was assessed through adverse event rates. Patient-reported visual outcomes were evaluated using the Visual Tasks questionnaire. The frequency and severity of visual disturbances were evaluated using the Assessment of Photic Phenomena and Lens EffectS questionnaire. The multifocal IOL (n = 155) provided better corrected distance visual acuity at 53 cm than the monofocal IOL (n = 165) (0.322 versus 0.512 logMAR; between-group difference, -0.190 logMAR; P < .0001) and 40 cm but not at 4 m. Ocular adverse event rates were less than 3.84% in both groups. Serious adverse event rates were comparable between the 2 IOL types. Patients with multifocal IOLs reported less difficulty with near tasks (with and without correction) and intermediate tasks (without correction). Difficulty with extended-intermediate and distance tasks was similar between groups. The most frequently reported self-rated severe phenomena were halos, starbursts, and glare. Most patients (monofocal ≥72%; multifocal ≥73%) reported never experiencing blurred, distorted, or double vision. The +2.5 D multifocal IOL provided better vision at 40 cm and 53 cm and similar vision at 4 m compared with the monofocal IOL. Safety profiles and visual phenomena were comparable between groups. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. A Double Slow Neutron Spectrometer; Spectrometre double pour neutrons lents; Dvojnoj spektrometr medlennykh nejtronov; Espectrometro doble para neutrones lentos

    Energy Technology Data Exchange (ETDEWEB)

    Bondarenko, I I; Liforov, V G; Nikolaev, M N; Orlov, V V; Parfenov, V A; Semenov, V A; Smirnov, V I; Turchin, V F [Fehi, Moscow, SSSR (Russian Federation)

    1963-01-15

    The neutron spectrometer described in the paper is intended for measurements of the angular and energy distribution of monochromatic slow neutrons, inelasticaily scattered by liquid and solid bodies. Experiments of this type permit detailed information to be obtained concerning the dynamics of the atoms in various aggregate states of a substance. The spectromeeter is based on the time-of-flight method. The pulse source of neutrons is the IBR (1) reactor. A mechanical interrupter, rotating synchronously with the disc of the IBR and having a prescribed phase shift, serves as the monochromator. A special phasing system ensures a phasee stability better than 0.5{sup o}. The neutrons scattered by the sample are recorded by a scintillation detector set at a given angle to the neutron beam. The resolving power of the spectrometer is - 15 {mu}s/m. The paper gives a detailed description of the construction of the spectroscope and its characteristics. (author) [French] Le spectrometre neutronique decrit dans le memoire est destine a mesurer la distribution en energie, la distribution angulaire et la diffusion inelastique des neutrons lents monochromatiques dans des liquides et des solides. Les experiences de ce genre permettent d'obtenir des renseignements detailles sur la dynamique des atomes dans de divers etats de la matiere. Le spectrometre est fonde sur la mesure du temps de vol. Comme source puisee de neutrons on a utilise le reacteur IBR-1. Le systeme monochromateur etait constitue par un interrupteur mecanique en rotation synchronisee avec celle du disque du reacteur IBR, avec un dephasage determine. Un dispositif special de dephasage assure la stabilite de la phase a 0,5{sup o} pres. La diffusion des neutrons par l'echantillon est enregistree a l'aide d'un detecteur a scintillations dispose sous un angle determine par rapport au faisceau de neutrons. Le pouvoir de resolution du spectrometre est d'environ 15 {mu}s/m. Les auteurs decrivent en detail la construction du

  19. Osteoblastomatosis of bone. A benign, multifocal osteoblastic lesion, distinct from osteoid osteoma and osteoblastoma, radiologically simulating a vascular tumor

    International Nuclear Information System (INIS)

    Kyriakos, Michael; El-Khoury, Georges Y.; McDonald, Douglas J.; Buckwalter, Joseph A.; Sundaram, Murali; DeYoung, Barry; O'Brien, Michael P.

    2007-01-01

    Two adult patients are described with multifocal osteolytic lesions radiologically simulating a vascular tumor. One patient had multiple bones involved. Histologically, the individual lesions had the features of the nidus of osteoid osteoma/osteoblastoma. A review of the English language medical literature yielded only one other reported case with similar features. The process is designated as osteoblastomatosis to indicate its bone-forming character, prominent osteoblast proliferation, and multiplicity. The cases are distinguished from multifocal/multicentric osteoid osteoma and osteoblastoma, and from benign and malignant vascular tumors. (orig.)

  20. Wide-field two-dimensional multifocal optical-resolution photoacoustic computed microscopy

    Science.gov (United States)

    Xia, Jun; Li, Guo; Wang, Lidai; Nasiriavanaki, Mohammadreza; Maslov, Konstantin; Engelbach, John A.; Garbow, Joel R.; Wang, Lihong V.

    2014-01-01

    Optical-resolution photoacoustic microscopy (OR-PAM) is an emerging technique that directly images optical absorption in tissue at high spatial resolution. To date, the majority of OR-PAM systems are based on single focused optical excitation and ultrasonic detection, limiting the wide-field imaging speed. While one-dimensional multifocal OR-PAM (1D-MFOR-PAM) has been developed, the potential of microlens and transducer arrays has not been fully realized. Here, we present the development of two-dimensional multifocal optical-resolution photoacoustic computed microscopy (2D-MFOR-PACM), using a 2D microlens array and a full-ring ultrasonic transducer array. The 10 × 10 mm2 microlens array generates 1800 optical foci within the focal plane of the 512-element transducer array, and raster scanning the microlens array yields optical-resolution photoacoustic images. The system has improved the in-plane resolution of a full-ring transducer array from ≥100 µm to 29 µm and achieved an imaging time of 36 seconds over a 10 × 10 mm2 field of view. In comparison, the 1D-MFOR-PAM would take more than 4 minutes to image over the same field of view. The imaging capability of the system was demonstrated on phantoms and animals both ex vivo and in vivo. PMID:24322226

  1. Multifocal epithelial hyperplasia in a community in the Mayan area of Mexico.

    Science.gov (United States)

    González-Losa, Maria R; Suarez-Allén, Rosa E; Canul-Canche, Jaqueline; Conde-Ferráez, Laura; Eljure-Lopez, Nixma

    2011-03-01

    Multifocal epithelial hyperplasia is a pathology of the oral mucosa which has been reported in diverse ethnic groups. Human papillomavirus (HPV) types 13 and 32 DNA has been detected in these lesions. The aims of this paper are to describe the epidemiological and clinical characteristics of an outbreak in a rural community in the Mayan area of Mexico and to identify a possible route of transmission through saliva. A cross-sectional study was conducted in Chemax (Yucatan, Mexico). Clinical and epidemiological data were obtained through direct interviews. Samples of oral cells and saliva were taken. HPV 13 and 32 were identified by polymerase chain reaction using specific primers. A total of 57 patients were studied, of whom 79.1% were aged jugal mucosa, and more frequently, the tongue. HPV 13 was found in all the patients and HPV 32 in none. A total of 42 saliva samples were positive for HPV 13. Human papillomavirus type 13 is involved in multifocal epithelial hyperplasia among the Mexican Mayan population. The presence of HPV 13 in cells from saliva, combined with poor hygiene behaviors, may explain the familial distribution of the pathology. © 2011 The International Society of Dermatology.

  2. Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens.

    Science.gov (United States)

    Akondi, Vyas; Pérez-Merino, Pablo; Martinez-Enriquez, Eduardo; Dorronsoro, Carlos; Alejandre, Nicolás; Jiménez-Alfaro, Ignacio; Marcos, Susana

    2017-04-01

    Standard evaluation of aberrations from wavefront slope measurements in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), results in large magnitude primary vertical coma, which is attributed to the intrinsic IOL design. The new proposed method analyzes aberrometry data, allowing disentangling the IOL power pupillary distribution from the true higher order aberrations of the eye. The new method of wavefront reconstruction uses retinal spots obtained at both the near and far foci. The method was tested using ray tracing optical simulations in a computer eye model virtually implanted with the Lentis Mplus IOL, with a generic cornea or with anterior segment geometry obtained from custom quantitative spectral-domain optical coherence tomography in a real patient. The method was applied to laser ray tracing aberrometry data at near and far fixation obtained in a patient implanted with the Lentis Mplus IOL. Higher order aberrations evaluated from simulated and real retinal spot diagrams following the new reconstruction approach matched the nominal aberrations (approximately 98%). Previously reported primary vertical coma in patients implanted with this IOL lost significance with the application of the proposed reconstruction. Custom analysis of ray tracing-based retinal spot diagrams allowed decoupling of the true higher order aberrations of the patient's eye from the power pupillary distribution of a rotationally asymmetric multifocal IOL, therefore providing the appropriate phase map to accurately evaluate through-focus optical quality. [J Refract Surg. 2017;33(4):257-265.]. Copyright 2017, SLACK Incorporated.

  3. Evaluation of Different Power of Near Addition in Two Different Multifocal Intraocular Lenses

    Directory of Open Access Journals (Sweden)

    Ugur Unsal

    2016-01-01

    Full Text Available Purpose. To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted. Methods. 41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later. Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50 and p=0.509, resp.. The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049, p=0.005, and p=0.001, resp. and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001. The patient satisfactions of both groups were similar. Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities, whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading.

  4. The brain triuno and the ethical intelligence: fundamental counterfoil of the multifocal intelligence

    Directory of Open Access Journals (Sweden)

    C. Seijo

    2013-10-01

    Full Text Available This study has for aim offer an analysis as for the brain triuno and the ethical intelligence: fundamental Counterfoil of the multifocal intelligence, taking in tells one of the theories that it sustains her like they are the different types of multiple intelligences established by Beauport and Cury (2004. The theoretical sustenance, it is based on the contents of Martin (2005, Belohlavek (2007, Galicians (2002, Beauport and Cury (2004, between others, being realized under a symbolic interpretive approach, across a qualitative methodology, type descriptive and not experimental design, by means of a documentary analysis. In this regard, it is found that the ethical intelligence is a mental mechanism that constructs the structural preconceptos and the rules of game with which an individual approaches the reality, that is to say, it is the capacity of the general formation, predicting the behavior for the achievement of aims organizacionales. As for the final considerations they focused in obtaining the most wide knowledge inside the organizations, allowing to reflect before the weaknesses that they present thinking about the brain triuno applying the multifocal intelligence, fundamental counterfoil of the ethical intelligence and of what way the rationing visualizes the strengths, nevertheless of the weaknesses that they present. 

  5. Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

    Directory of Open Access Journals (Sweden)

    Raffaele Nuzzi

    2017-07-01

    Full Text Available After penetrating keratoplasty (PK, high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis. We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°. The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

  6. Progressive Multifocal Leukoencephalopathy: Recent Advances and a Neuro-Ophthalmological Review.

    Science.gov (United States)

    Sudhakar, Padmaja; Bachman, David M; Mark, Alexander S; Berger, Joseph R; Kedar, Sachin

    2015-09-01

    Progressive multifocal leukoencephalopathy (PML) is a severe often fatal opportunistic infection of the central nervous system caused by reactivation of a ubiquitous polyoma virus, JC virus. Although typically characterized by multifocal asymmetric subcortical white matter lesions, it may be monofocal and affect the cortical gray matter. Among the broad spectrum of clinical manifestations that occurs with PML, visual complaints are common. Combination of representative personally observed cases of PML and comprehensive review of case series of PML from 1958 through 2014. Neuro-ophthalmic signs and symptoms were reported in approximately 20%-50% of patients with PML and can be the presenting manifestation in half of these. A majority of these presentations occur from damage to cerebral visual pathways resulting in visual field defects, cortical blindness, and other disorders of visual association. Given the decreased frequency of infratentorial and cerebellar involvement, ocular motility disorders are less common. Visual complaints occur in patients with PML and are often the presenting sign. Awareness of this condition is helpful in avoiding unnecessary delays in the diagnosis of PML and management of the underlying condition. Recent guidelines have established criteria for diagnosis of PML in the high-risk patient population and strategies to mitigate the risk in these populations.

  7. Multifocal fibrosclerosis and IgG4-related disease involving the cardiovascular system

    International Nuclear Information System (INIS)

    Ishizaka, Nobukazu; Terasaki, Fumio; Sakamoto, Aiko; Imai, Yasushi; Nagai, Ryozo

    2012-01-01

    The cardiovascular system may be involved as a target organ of multifocal fibrosclerosis, which may manifest as idiopathic retroperitoneal fibrosis, inflammatory aortic aneurysm, inflammatory periarteritis, and inflammatory pericarditis. These pathological conditions can sometimes occur concomitantly. Idiopathic retroperitoneal fibrosis and inflammatory abdominal aortic aneurysm are both characterized by the presence of fibro-inflammatory tissue around the abdominal aorta expanding into the surrounding retroperitoneal structures, and together they may be termed 'chronic periaortitis'. Cardiovascular fibrosclerosis has become non-uncommonly encountered condition since imaging modalities have made its diagnosis more feasible. In addition, recent studies have demonstrated that a certain fraction, but not all, of cardiovascular fibrosclerosis may have a link with immunoglobulin-G4 (IgG4)-related sclerosing disease (IgG4-SD). IgG4-SD is histologically characterized by dense fibrosclerosis and infiltration of lymphocytes and IgG4-positive plasma cells, and these histopathologic findings seem to be essentially similar regardless of the organs involved. In this mini review, we summarize what is known so far about multifocal fibrosclerosis of the cardiovascular system and its association with IgG4-SD, and what remains to be clarified in future investigations. (author)

  8. Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

    Science.gov (United States)

    Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

    2015-01-01

    To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  9. Individualized laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer.

    Science.gov (United States)

    Xu, Zhifeng; Yang, Zhangwei; Pan, Jianghua; Hu, Yiren

    2018-03-01

    Liver cancer is one of the most common malignancies of the digestive system. Minimally invasive ablation procedures have become one of the major means for treating unresectable multifocal liver cancer and have been extensively applied in primary and metastatic liver cancer treatment. Laparoscopic B-ultrasound-guided microwave ablation is an example of the progress made in this field. To analyze and summarize the results of and experience with laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer; moreover, the ablation effects were compared between tumors of different sizes. Laparoscope-guided needle ablation was conducted on 84 lesions from 32 patients with primary liver cancer based on tumor size, quantity, and location. Moreover, the perioperative data, ablation effects according to tumor size, and long-term follow-up results were analyzed. Among the 84 nodules treated via microwave ablation, tumors measuring ≤ 3 cm demonstrated complete ablation upon imaging analysis conducted 1 month after surgery. Moreover, 5 of the tumors measuring > 3 cm demonstrated incomplete ablation. In these cases, a second procedure was performed, until imaging studies confirmed that complete ablation was achieved. Laparoscopic microwave ablation allows for precise puncture positioning, an effective ablation range, and safe and feasible surgery, which is especially suitable for liver tumors located in sites difficult to access.

  10. Locally aggressive and multifocal phosphaturic mesenchymal tumors: two unusual cases of tumor-induced osteomalacia.

    Science.gov (United States)

    Higley, Meghan; Beckett, Brooke; Schmahmann, Sandra; Dacey, Elizabeth; Foss, Erik

    2015-12-01

    Tumor-induced osteomalacia (TIO) has long been recognized as a clinical paraneoplastic syndrome. The identification of a unique histopathologic entity, the phosphaturic mesenchymal tumor (PMT), as a distinct etiology for TIO has been a more recent discovery. The majority of published cases describe a solitary, non-aggressive appearing soft tissue or osseous lesions in patients with osteomalacia; aggressive appearing or multifocal lesions appear to be exceedingly rare. These tumors characteristically secrete fibroblast growth factor 23 (FGF23). Elevated serum levels of FGF23 result in phosphate wasting and osteomalacia. In the majority of cases, laboratory abnormalities and clinical signs and symptoms of osteomalacia precede identification of the causative lesion by years. Following diagnosis, complete resection with wide margins to prevent local recurrence is most often curative. Imaging characteristics of PMT are diverse and remain incompletely defined, as the majority of previous publications are outside of the radiologic literature. We present multiple imaging modalities in two cases of patients with debilitating osteomalacia and unusual appearing PMTs: one with a locally aggressive lesion leading to pathologic fracture, the second presenting with exceedingly rare multifocal PMT.

  11. Perfil demográfico e comportamental de pacientes com indicação médica óptica de lentes de contato

    Directory of Open Access Journals (Sweden)

    Fernanda Lika Tabushi

    Full Text Available RESUMO Objetivos: Avaliar o perfil demográfico e comportamental de pacientes com indicação médica óptica de lentes de contato (LC em um hospital público de Curitiba. Métodos: Estudo transversal realizado através de questionário em pacientes atendidos no serviço de lentes de contato do ambulatório do SUS do Hospital de Olhos do Paraná, no período de 02 de setembro de 2014 a 04 de agosto de 2015. Resultados: Dos 69 entrevistados, 56,52% fizeram LC. Destes, 55,07% têm entre 20-49 anos, 69,56% são mulheres, 40,58% com ensino médio completo e 36,23% com 2 a 6 salários mínimos. Predominaram a lente rígida com 66,67%, com menos de 8 horas de uso em 41,02% e desconforto durante o uso em 59%. A limpeza das LC é feita ao colocar e ao retirar em 87,18% dos casos, com 71,8% utilizando solução própria para LC. Alto custo da compra foi o principal motivo do não uso de LC, com 70% dos pacientes que não fizeram uso desse recurso. Conclusões: Dos entrevistados, 56,52% iniciaram o uso de LC, sendo o ceratocone a doença mais indicada. Foi demonstrado nesse estudo que os pacientes em questão têm boa orientação quanto a manuseio e manutenção das LC. Apesar dos inquestionáveis avanços da tecnologia médica, continuam ocorrendo a desistência do uso desse recurso principalmente pelo custo e medo do manuseio. É responsabilidade do especialista esclarecer os benefícios que os pacientes com indicação médica terão com o uso de LC, assim como motivar o seu uso.

  12. In-the-bag decentration of a hydrophilic radially asymmetric multifocal intraocular lens secondary to capsule contraction.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

    2013-01-01

    We report a case of in-the-bag decentration and tilt of a hydrophilic rotationally asymmetric multifocal intraocular lens (IOL) of the M Plus type secondary to capsule contraction. After uneventful surgery and follow-up for 3 months, progressive decentering and tilting of the IOL secondary to

  13. Efeito do uso de lente escleral cosmética na sensibilidade tátil corneal em phthisis bulbi Effect of ocular prosthesis on cornea sensitivity in phthisis bulbi

    Directory of Open Access Journals (Sweden)

    Lucia Miriam Dumont Lucci

    2004-10-01

    Full Text Available OBJETIVOS: Comparar a sensibilidade tátil corneal entre olhos normais e aqueles com phthisis bulbi e avaliar as alterações provocadas na sensibilidade tátil corneal pelo uso de lente escleral cosmética em phthisis bulbi. MÉTODOS: Estudo prospectivo de 23 pacientes com phthisis bulbi unilateral. Foram realizadas medidas da sensibilidade tátil corneal em ambos os olhos utilizando-se o estesiômetro de Cochet-Bonnet antes e após 3 meses do uso da lente escleral cosmética. RESULTADOS: Em todos os pacientes, a medida da sensibilidade tátil corneal no olho com phthisis bulbi foi menor do que no contralateral (controle. Em 96% houve diminuição da sensibilidade tátil corneal após a adaptação da lente escleral cosmética. CONCLUSÃO: Após a adaptação da lente escleral cosmética, ocorre diminuição da sensibilidade tátil corneal nos olhos. A fisiopatologia é semelhante à encontrada nos usuários de lentes de contato.PURPOSE: To compare corneal sensitivity between normal eyes and those whith phthisis bulbi and also to analyze the alterations of corneal sensitivity in phthisis bulbi induced by wearing ocular prosthesis. METHODS: Prospective study of 23 patients with unilateral phthisis bulbi. Bilateral cornea sensitivity was evaluated using the Cochet-Bonnet esthesiometer before and after 3 months of wearing ocular prosthesis. RESULTS: In all patients, corneal sensitivity of the eye with phthisis bulbi was lower than that of the normal eye (control. In 96% there was decrease of corneal sensitivity after adaptation of ocular prosthesis. CONCLUSION: After wearing ocular prosthesis, there is a reduction in corneal sensitivity in phthisis bulbi. The pathophysiology seems to be the same as that found in contact lens wearers.

  14. Multifocal Visual Evoked Potential in Eyes With Temporal Hemianopia From Chiasmal Compression: Correlation With Standard Automated Perimetry and OCT Findings.

    Science.gov (United States)

    Sousa, Rafael M; Oyamada, Maria K; Cunha, Leonardo P; Monteiro, Mário L R

    2017-09-01

    To verify whether multifocal visual evoked potential (mfVEP) can differentiate eyes with temporal hemianopia due to chiasmal compression from healthy controls. To assess the relationship between mfVEP, standard automated perimetry (SAP), and Fourier domain-optical coherence tomography (FD-OCT) macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements. Twenty-seven eyes with permanent temporal visual field (VF) defects from chiasmal compression on SAP and 43 eyes of healthy controls were submitted to mfVEP and FD-OCT scanning. Multifocal visual evoked potential was elicited using a stimulus pattern of 60 sectors and the responses were averaged for the four quadrants and two hemifields. Optical coherence tomography macular measurements were averaged in quadrants and halves, while peripapillary RNFL thickness was averaged in four sectors around the disc. Visual field loss was estimated in four quadrants and each half of the 24-2 strategy test points. Multifocal visual evoked potential measurements in the two groups were compared using generalized estimated equations, and the correlations between mfVEP, VF, and OCT findings were quantified. Multifocal visual evoked potential-measured temporal P1 and N2 amplitudes were significantly smaller in patients than in controls. No significant difference in amplitude was observed for nasal parameters. A significant correlation was found between mfVEP amplitudes and temporal VF loss, and between mfVEP amplitudes and the corresponding OCT-measured macular and RNFL thickness parameters. Multifocal visual evoked potential amplitude parameters were able to differentiate eyes with temporal hemianopia from controls and were significantly correlated with VF and OCT findings, suggesting mfVEP is a useful tool for the detection of visual abnormalities in patients with chiasmal compression.

  15. Nerve sonography in multifocal motor neuropathy and chronic inflammatory demyelinating polyneuropathy

    Directory of Open Access Journals (Sweden)

    D. S. Druzhinin

    2016-01-01

    Full Text Available The quantitative ultrasound characteristics (USC of the median, ulnar nerve at different levels and the spinal nerves in patients with multifocal motor neuropathy (MMN; n=13; 40,4 ± 12,6 years old and chronic inflammatory demyelinating polyneuropathy (CIDP; n = 7; 47,3 ± 11,2 year old did not reveal statistical difference in cross sectional area (CSA between analyzed groups. Patients with MMN have more pronounced asymmetry of CSA in comparison with CIDP patients which have a symmetrical pattern of diffuse nerve involvement. Quantitative USC has shown to be not informative enough in differentiation of MMN and CIDP. The qualitative analysis (QA according to 3 described types of nerve changes has shown that CIDP is characterized by the prevalence of type 3 pattern (85.8 % while MMN – by type 2 (69.2 %. The sensitivity and specificity of proposed QA patterns in nerve USC need to be analyzed in additional investigations. 

  16. Adaptive panoramic tomography with a circular rotational movement for the formation of multifocal image layers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D. S.; Cho, H. S.; Park, Y. O.; Je, U. K.; Hong, D. K.; Choi, S. I.; Koo, Y. S. [Yonsei University, Wonju (Korea, Republic of)

    2012-02-15

    Panoramic radiography with which only structures within a certain image layer are in focus and others out of focus on the panoramic image has become a popular imaging technique especially in dentistry. However, the major drawback to the technique is a mismatch between the structures to be focused and the predefined image layer mainly due to the various shapes and sizes of dental arches and/or to malpositioning of the patient. These result in image quality typically inferior to that obtained using intraoral radiographic techniques. In this paper, to overcome these difficulties, we suggest a new panoramic reconstruction algorithm, the so-called adaptive panoramic tomography (APT), capable of reconstructing multifocal image layers with no additional exposure. In order to verify the effectiveness of the proposed algorithm, we performed systematic simulation studies with a circular rotational movement and investigated the image performance.

  17. Squamous Cell Carcinoma of the Larynx Arising in Multifocal Pharyngolaryngeal Oncocytic Papillary Cystadenoma

    Science.gov (United States)

    Stenner, Markus; Müller, Klaus-Michael; Koopmann, Mario; Rudack, Claudia

    2014-01-01

    Abstract We report on a rare case of a laryngeal carcinoma arising in a multifocal pharyngolaryngeal oncocytic papillary cystadenoma (OPC). The disease of a 63-year-old man is well documented by computed and positron emission tomography, histology, and electron microscopy. We could show that an OPC can even develop in the pharynx. The coexistence of both tumors makes this a challenging diagnosis for pathologists. Treated by surgery and radiotherapy, both lesions dissolved. Based on the literature available, we discuss the theory that the laryngeal carcinoma might be the result of a true metaplasia facilitated by chronic irritation and recommend a regular follow-up for OPC too. As in benign oncocytic lesions, we could show that the detection of numerous mitochondria is a diagnostic indicator for malignant variants as well. PMID:25211046

  18. Chronic recurrent multifocal osteomyelitis with an atypical presentation in an adult man

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Cheng William [University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Cleveland Clinic, Lerner College of Medicine, Cleveland, OH (United States); Hsiao, Edward C. [University of California San Francisco, Division of Endocrinology and Metabolism, and the Institute for Human Genetics, Department of Medicine, San Francisco, CA (United States); Horvai, Andrew E. [University of California San Francisco, Department of Pathology, San Francisco, CA (United States); Link, Thomas M. [University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

    2015-09-15

    We present the case of a 33-year-old man with no significant medical history who developed right scapular pain, left-sided sacroiliac joint pain, and lower back pain, and was eventually diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). Imaging demonstrated multiple scattered T2-hyperintense lesions on MRI at the spine and the left SI joint, some of which progressed and one regressed in size on follow-up. Histopathology demonstrated only non-specific chronic inflammation compatible with CRMO. No evidence of infectious organisms or neoplastic processes was found. The pain was relapsing and remitting in nature. Laboratory investigations were notable for no evidence of hematologic malignancy or infection, but only a mild increase in alkaline phosphatase. This case highlights that CRMO, despite being thought of as a childhood-onset disease, can present in adults as well, and also provides illustrative examples of imaging and histological findings. (orig.)

  19. Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers.

    Science.gov (United States)

    Fernandes, Ana R; Santos, Ana C; Sanchez-Lopez, Elena; Kovačević, Andjekla B; Espina, Marta; Calpena, Ana C; Veiga, Francisco J; Garcia, Maria L; Souto, Eliana B

    2018-01-01

    Neoplastic skin lesions are multifocal, diffuse skin infiltrations of particular relevance in the differential diagnosis of ulcerative, nodular, or crusting skin lesions. Nonmelanoma skin cancers (NMSCs), namely, basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and also actinic keratosis (AK), are the most common malignant tumors in humans. BCCs do not proliferate rapidly and most of the times do not metastasize, while SCCs are more infiltrative, metastatic, and destructive. AKs are precursor lesions of cutaneous SCCs. The classical therapy of NMSCs makes use of photodynamic therapy associated with chemotherapeutics. With improved understanding of the pathological mechanisms of tumor initiation, progression, and differentiation, a case is made towards the use of targeted chemotherapy with the intent to reduce the cytotoxicity of classical treatments. The present review aims to describe the current state of the art on the knowledge of NMSC, including its risks factors, oncogenes, and skin carcinogenesis, discussing the classical therapy against new therapeutic options. © 2017 S. Karger AG, Basel.

  20. Multifocal scalp abscess with subcutaneous fat necrosis and scarring alopecia as a complication of scalp mesotherapy.

    Science.gov (United States)

    Kadry, Razan; Hamadah, Issam; Al-Issa, Abdullah; Field, Lawrence; Alrabiah, Fahad

    2008-01-01

    Over the past several years, there has been a growing interest in the treatment method termed mesotherapy. Marketed for nonsurgical fat melting, skin rejuvenation, and hair regrowth, this technique has become increasingly popular and, in the public's view, it is considered to be a relatively benign intervention method. Mesotherapy was introduced over 50 years ago by M. Pistor, a French physician who utilized this technique initially as a novel analgesic therapeutic method for a variety of rheumatologic disorders. Since its introduction, the basic principal of locally injecting subcutaneous doses of varying chemicals has been expanded and is now utilized for the aforementioned cosmetic concerns. With its increased popularity, there has been an increase in the number of reported side effects resulting from mesotherapeutic intervention. We report multifocal scalp abscesses with subcutaneous fat necrosis as a direct result of mesotherapy; therefore, requiring extensive surgical repair.

  1. Risk stratification for progressive multifocal leukoencephalopathy in patients treated with natalizumab

    DEFF Research Database (Denmark)

    Sørensen, Per Soelberg; Bertolotto, Antonio; Edan, Gilles

    2012-01-01

    using or considering natalizumab therapy. Recommendations for clinical management of patients with MS and use of natalizumab are provided based on the presence of these three risk factors. The identification of risk factors that increase the likelihood of PML in natalizumab-treated patients can......Natalizumab is a highly effective immunomodulator in the treatment of multiple sclerosis (MS). Treatment with natalizumab has been associated with progressive multifocal leukoencephalopathy (PML), an infection of the central nervous system (CNS) caused by a pathogenic form of the normally benign JC......-treated patients. With the development of a reliable and validated assay for detection of antibodies in patients with MS directed against JCV, it is now possible to identify persons who are carriers of JCV. The availability of this assay provides an additional option for risk stratification of PML in patients...

  2. Assessment of hydroxychloroquine maculopathy after cessation of treatment: an optical coherence tomography and multifocal electroretinography study.

    Science.gov (United States)

    Moschos, Marilita M; Nitoda, Eirini; Chatziralli, Irini P; Gatzioufas, Zisis; Koutsandrea, Chryssanthi; Kitsos, George

    2015-01-01

    This study was conducted to evaluate the macular status of patients treated with hydroxychloroquine before and after cessation of treatment. Forty-two patients with systemic lupus erythematosus underwent ocular examination based on visual acuity evaluation, optical coherence tomography retinal thickness measurements, and multifocal electroretinography (mfERG) records at first visit. The tests were repeated 6 months after treatment withdrawal and compared to the findings at their first visit. Mean visual acuity (measured in log minimum angle of resolution) of both eyes was statistically increased after hydroxychloroquine discontinuation (difference in means: 0.06 [Phydroxychloroquine improves along with the amplitudes of the mfERG responses 6 months after discontinuation of the drug, but no difference in retinal thickness is identified.

  3. Late relapse of progressive multifocal leucoencephalopathy postallogenic transplant in a young patient with CLL.

    Science.gov (United States)

    Sanchez-Quintana, Ana; Breña-Atienza, Joaquín; Marrero-Santos, Carmen; Alvarez-Acosta, Luis

    2013-08-05

    We describe a case of progressive multifocal leucoencephalopathy (PML) in a 39-year-old patient diagnosed with chronic lymphocytic leukaemia (CLL) who underwent two allogenic matched-sibling stem cell transplantations. PML was confirmed just after the first transplantation with cerebral MRI and by PCR in the cerebrospinal fluid. After immunosuppression withdrawal and cidofovir treatment, he achieved a reversal of clinical symptoms, John Cunningham (JC) virus positivity and MRI lesions regression. He remained asymptomatic for 5 years with no signs of infection activity, even though he received three new chemotherapy regimens due to a CLL relapse. However, after the second stem cell transplantation, new neurological symptoms began and a reactivation of the JC virus infection was detected. This time, treatment with mefloquine was started, but he experienced a progressive neurological deterioration and died 1 month after the symptoms began.

  4. Multifocal Choroiditis with Retinal Vasculitis, Optic Neuropathy, and Keratoconus in a Young Saudi Male.

    Science.gov (United States)

    Dhafiri, Yousef; Al Rubaie, Khalid; Kirat, Omar; May, William N; Nguyen, Quan D; Kozak, Igor

    2017-01-01

    The purpose of this study is to describe an association of unilateral multifocal choroiditis (MFC), retinal vasculitis, optic neuropathy, and bilateral keratoconus in a young Saudi male. A 27-year-old male patient with stable bilateral keratoconus presented with a painless vision loss in his left eye. Ophthalmic examinations revealed multiple foci of idiopathic chorioretinitis, retinal vasculitis, and mild optic disc leakage on fluorescein angiography, all of which resolved on systemic therapy with mycophenolate mofetil and prednisone after 3 months. Systemic medication was stopped after 8 months. One year after presentation, patient's visual acuity has improved and remained stable. Systemic immunomodulatory therapy can be effective in managing and leading to resolution of MFC, retinal vasculitis, and optic disc leak in young patients.

  5. Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica.

    Science.gov (United States)

    Berger, Joseph R; Neltner, Janna; Smith, Charles; Cambi, Franca

    2014-11-01

    Both progressive multifocal leukoencephalopathy (PML) and posterior reversible encephalopathy syndrome (PRES) have been reported as complications of rituximab therapy. These disorders may appear indistinguishable on magnetic resonance imaging (MRI). We report on a 42 year old woman with neuromyelitis optica (NMO) of 10 years duration who developed extensive white matter disease affecting chiefly both parietal lobes 6 months after her first and only dose of rituximab. The MRI findings suggested the diagnosis of PML, but her history was more consistent with PRES. Ultimately, a brain biopsy was performed which was consistent with the diagnosis of PRES. PRES and PML may have overlapping symptomatology and be indistinguishable on MRI. An approach to distinguishing between these two disorders is addressed. Copyright © 2014. Published by Elsevier B.V.

  6. Improvement of the classification accuracy in discriminating diabetic retinopathy by multifocal electroretinogram analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The multifocal electroretinogram (mfERG) is a newly developed electrophysiological technique. In this paper, a classification method is proposed for early diagnosis of the diabetic retinopathy using mfERG data. MfERG records were obtained from eyes of healthy individuals and patients with diabetes at different stages. For each mfERG record, 103 local responses were extracted. Amplitude value of each point on all the mfERG local responses was looked as one potential feature to classify the experimental subjects. Feature subsets were selected from the feature space by comparing the inter-intra distance. Based on the selected feature subset, Fisher's linear classifiers were trained. And the final classification decision of the record was made by voting all the classifiers' outputs. Applying the method to classify all experimental subjects, very low error rates were achieved. Some crucial properties of the diabetic retinopathy classification method are also discussed.

  7. Multifocal Epithelioid Hemangioendothelioma Derived from the Spine Region: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    G. Kerry

    2012-02-01

    Full Text Available Background: Epithelioid hemangioendothelioma (EHE is a rare vascular tumor with malignant biological behavior. It arises from endothelial cells, usually within soft tissues, and can occur in almost all locations. Case Report: We report a unique case of a 25-year-old man who presented with sudden attacks of severe back pain followed by acute non-traumatic paraplegia. Emergency diagnostics revealed a pathologic fracture of the T7 vertebra with tumor tissue invasion of the spinal canal. Furthermore, multifocal metastases were found. Results: To achieve en bloc resection, interdisciplinary surgical approaches were indicated. Despite multimodal therapy concepts, including radiotherapy and chemotherapy as well as endovascular embolization, the patient died within 8 weeks. Conclusion: Prognosis of EHE is unpredictable and mainly determined by its location. The lesions are potentially aggressive; therefore, en bloc resection should be attempted whenever possible. However, as shown in the literature, only 15% of patients are suitable for total resection.

  8. TBC1D24 Mutations in a Sibship with Multifocal Polymyoclonus

    Directory of Open Access Journals (Sweden)

    Adeline Ngoh

    2017-04-01

    Full Text Available Background: Advances in molecular genetic technologies have improved our understanding of genetic causes of rare neurological disorders with features of myoclonus.Case Report: A family with two affected siblings, presenting with multifocal polymyoclonus and neurodevelopmental delay, was recruited for whole-exome sequencing following unyielding diagnostic neurometabolic investigations. Compound heterozygous mutations in TBC1D24, a gene previously associated with various epilepsy phenotypes and hearing loss, were identified in both siblings. The mutations included a missense change c.457G>A (p.Glu157Lys, and a novel frameshift mutation c.545del (p.Thr182Serfs*6.Discussion: We propose that TBC1D24-related diseases should be in the differential diagnosis for children with polymyoclonus. 

  9. Chronic recurrent multifocal osteomyelitis with an atypical presentation in an adult man

    International Nuclear Information System (INIS)

    Hong, Cheng William; Hsiao, Edward C.; Horvai, Andrew E.; Link, Thomas M.

    2015-01-01

    We present the case of a 33-year-old man with no significant medical history who developed right scapular pain, left-sided sacroiliac joint pain, and lower back pain, and was eventually diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). Imaging demonstrated multiple scattered T2-hyperintense lesions on MRI at the spine and the left SI joint, some of which progressed and one regressed in size on follow-up. Histopathology demonstrated only non-specific chronic inflammation compatible with CRMO. No evidence of infectious organisms or neoplastic processes was found. The pain was relapsing and remitting in nature. Laboratory investigations were notable for no evidence of hematologic malignancy or infection, but only a mild increase in alkaline phosphatase. This case highlights that CRMO, despite being thought of as a childhood-onset disease, can present in adults as well, and also provides illustrative examples of imaging and histological findings. (orig.)

  10. Multifocal visual evoked potentials for quantifying optic nerve dysfunction in patients with optic disc drusen

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; de Santiago, Luis; Boquete, Luciano

    2017-01-01

    and 22 control subjects were examined. Mean amplitude, mean inner ring (IR) amplitude (0.87-5.67° of visual field) and mean outer ring amplitude (5.68-24° of visual field) were calculated using signal-to-noise ratio (SNR) and peak-to-peak analysis. Monocular latency was calculated using second peak......PURPOSE: To explore the applicability of multifocal visual evoked potentials (mfVEPs) for research and clinical diagnosis in patients with optic disc drusen (ODD). This is the first assessment of mfVEP amplitude in patients with ODD. METHODS: MfVEP amplitude and latency from 33 patients with ODD......, full eye and IR. In the control group, SNR intersubject variability was 17.6% and second peak latency intersubject variability was 2.8%. CONCLUSION: Decreased mfVEP amplitude in patients with ODD suggests a direct mechanical compression of the optic nerve axons. Our results suggest that mfVEP amplitude...

  11. Rare lung manifestation of multifocal micronodular pneumocyte hyperplasia in a teenage girl with tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Seung Mi; Yoon, Hye Kyung; Lee, Seung Koo [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-08-15

    Multifocal micronodular pneumocyte hyperplasia (MMPH) is a relatively rare pulmonary disorder that can be associated with tuberous sclerosis complex (TSC). It has been rarely reported in children or adolescents. MMPH is a hamartomatous process of the lung with multiple small nodules, composed of type II pneumocytes. Plain radiography and chest CT in MMPH may demonstrate numerous small nodules measuring 1-10 mm in diameters, distributed randomly throughout both lungs. If MMPH is an initial presentation of TSC, and unless we are familiar with this lung manifestation of TSC, radiologic findings can mimic miliary tuberculosis or metastatic disease. We report a teenage girl with TSC and histologically confirmed MMPH which mimicked miliary tuberculosis at the initial presentation.

  12. Rare lung manifestation of multifocal micronodular pneumocyte hyperplasia in a teenage girl with tuberous sclerosis complex

    International Nuclear Information System (INIS)

    Ha, Seung Mi; Yoon, Hye Kyung; Lee, Seung Koo

    2016-01-01

    Multifocal micronodular pneumocyte hyperplasia (MMPH) is a relatively rare pulmonary disorder that can be associated with tuberous sclerosis complex (TSC). It has been rarely reported in children or adolescents. MMPH is a hamartomatous process of the lung with multiple small nodules, composed of type II pneumocytes. Plain radiography and chest CT in MMPH may demonstrate numerous small nodules measuring 1-10 mm in diameters, distributed randomly throughout both lungs. If MMPH is an initial presentation of TSC, and unless we are familiar with this lung manifestation of TSC, radiologic findings can mimic miliary tuberculosis or metastatic disease. We report a teenage girl with TSC and histologically confirmed MMPH which mimicked miliary tuberculosis at the initial presentation

  13. Chronic Recurrent Multifocal Osteomyelitis in a 9-year-old Boy

    Directory of Open Access Journals (Sweden)

    Abdolreza Malek

    2017-05-01

    Full Text Available Chronic recurrent multifocal osteomyelitis (CRMO is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment. Herein, we present a nine-year-old boy complaining of recurrent pain in his upper and lower extremities. On examination he had mild fever and cervical lymphadenopathy. He also had experienced bone pain and weight loss in the recent month. Based on biopsy and bone scan he was finally diagnosed with CRMO. Naproxen and Pamidronate was prescribed and he was getting better and returned to normal life and activity without need to corticosteroids.

  14. Renal hemodynamics and renin-angiotensin system activity in humans with multifocal renal artery fibromuscular dysplasia.

    Science.gov (United States)

    van Twist, Daan J L; Houben, Alphons J H M; de Haan, Michiel W; de Leeuw, Peter W; Kroon, Abraham A

    2016-06-01

    Fibromuscular dysplasia (FMD) is the second most common cause of renovascular hypertension. Nonetheless, knowledge on the renal microvasculature and renin-angiotensin system (RAS) activity in kidneys with FMD is scarce. Given the fairly good results of revascularization, we hypothesized that the renal microvasculature and RAS are relatively spared in kidneys with FMD. In 58 hypertensive patients with multifocal renal artery FMD (off medication) and 116 matched controls with essential hypertension, we measured renal blood flow (Xenon washout method) per kidney and drew blood samples from the aorta and both renal veins to determine renin secretion and glomerular filtration rate per kidney. We found that renal blood flow and glomerular filtration rate in FMD were comparable to those in controls. Although systemic renin levels were somewhat higher in FMD, renal renin secretion was not elevated. Moreover, in patients with unilateral FMD, no differences between the affected and unaffected kidney were observed with regard to renal blood flow, glomerular filtration rate, or renin secretion. In men, renin levels and renin secretion were higher as compared with women. The renal blood flow response to RAS modulation (by intrarenal infusion of angiotensin II, angiotensin-(1-7), an angiotensin II type 1 receptor blocker, or a nitric oxide synthase blocker) was also comparable between FMD and controls. Renal blood flow, glomerular filtration, and the response to vasoactive substances in kidneys with multifocal FMD are comparable to patients with essential hypertension, suggesting that microvascular function is relatively spared. Renin secretion was not increased and the response to RAS modulation was not affected in kidneys with FMD.

  15. Can the accuracy of multifocal intraocular lens power calculation be improved to make patients spectacle free?

    Science.gov (United States)

    Ramji, Hasnain; Moore, Johnny; Moore, C B Tara; Shah, Sunil

    2016-04-01

    To optimise intraocular lens (IOL) power calculation techniques for a segmental multifocal IOL, LENTIS™ MPlus(®) (Oculentis GmbH, Berlin, Germany) and assess outcomes. A retrospective consecutive non-randomised case series of patients receiving the MPlus(®) IOL following cataract surgery or clear lens extraction was performed at a privately owned ophthalmic hospital, Midland Eye, Solihull, UK. Analysis was undertaken of 116 eyes, with uncomplicated lens replacement surgery using the LENTIS™ MPlus(®) lenses. Pre-operative biometry data were stratified into short (<22.00 mm) and long axial lengths (ALs) (≥22.00 mm). IOL power predictions were calculated with SRK/T, Holladay I, Hoffer Q, Holladay II and Haigis formulae and compared to the final manifest refraction. These were compared with the OKULIX ray tracing method and the stratification technique suggested by the Royal College of Ophthalmologists (RCOphth). Using SRK/T for long eyes and Hoffer Q for short eyes, 64% achieved postoperative subjective refractions of ≤±0.25 D, 83%≤±0.50 D and 93%≤±0.75 D, with a maximum predictive error of 1.25D. No specific calculation method performed best across all ALs; however for ALs under 22 mm Hoffer Q and Holliday I methods performed best. Excellent but equivalent overall refractive results were found between all biometry methods used in this multifocal IOL study. For eyes with ALs under 22 mm Hoffer Q and Holliday I performed best. Current techniques mean that patients are still likely to need top up glasses for certain situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Piggyback intraocular lens implantation to correct pseudophakic refractive error after segmental multifocal intraocular lens implantation.

    Science.gov (United States)

    Venter, Jan A; Oberholster, Andre; Schallhorn, Steven C; Pelouskova, Martina

    2014-04-01

    To evaluate refractive and visual outcomes of secondary piggyback intraocular lens implantation in patients diagnosed as having residual ametropia following segmental multifocal lens implantation. Data of 80 pseudophakic eyes with ametropia that underwent Sulcoflex aspheric 653L intraocular lens implantation (Rayner Intraocular Lenses Ltd., East Sussex, United Kingdom) to correct residual refractive error were analyzed. All eyes previously had in-the-bag zonal refractive multifocal intraocular lens implantation (Lentis Mplus MF30, models LS-312 and LS-313; Oculentis GmbH, Berlin, Germany) and required residual refractive error correction. Outcome measurements included uncorrected distance visual acuity, corrected distance visual acuity, uncorrected near visual acuity, distance-corrected near visual acuity, manifest refraction, and complications. One-year data are presented in this study. The mean spherical equivalent ranged from -1.75 to +3.25 diopters (D) preoperatively (mean: +0.58 ± 1.15 D) and reduced to -1.25 to +0.50 D (mean: -0.14 ± 0.28 D; P < .01). Postoperatively, 93.8% of eyes were within ±0.50 D and 98.8% were within ±1.00 D of emmetropia. The mean uncorrected distance visual acuity improved significantly from 0.28 ± 0.16 to 0.01 ± 0.10 logMAR and 78.8% of eyes achieved 6/6 (Snellen 20/20) or better postoperatively. The mean uncorrected near visual acuity changed from 0.43 ± 0.28 to 0.19 ± 0.15 logMAR. There was no significant change in corrected distance visual acuity or distance-corrected near visual acuity. No serious intraoperative or postoperative complications requiring secondary intraocular lens removal occurred. Sulcoflex lenses proved to be a predictable and safe option for correcting residual refractive error in patients diagnosed as having pseudophakia. Copyright 2014, SLACK Incorporated.

  17. Visual outcomes after implantation of a novel refractive toric multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Talita Shimoda

    2014-04-01

    Full Text Available Purpose: To assess the postoperative outcomes of a novel toric multifocal in traocular lens (IOL in patients with cataract and corneal astigmatism. Methods: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. Results: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC was -2.19 (SD: ± 0.53. After a 3-month follow-up, the average RC was -0.44 D (SD: ± 0.27; p<0.001. Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. Conclusion: Toric multifocal IOL implantation in patients with cataract and corneal astigmatism using the Rayner M-flex® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence.

  18. Chromatic Multifocal Pupillometer for Objective Perimetry and Diagnosis of Patients with Retinitis Pigmentosa.

    Science.gov (United States)

    Chibel, Ron; Sher, Ifat; Ben Ner, Daniel; Mhajna, Mohamad O; Achiron, Asaf; Hajyahia, Soad; Skaat, Alon; Berchenko, Yakir; Oberman, Bernice; Kalter-Leibovici, Ofra; Freedman, Laurence; Rotenstreich, Ygal

    2016-09-01

    To assess visual field (VF) defects and retinal function objectively in healthy participants and patients with retinitis pigmentosa (RP) using a chromatic multifocal pupillometer. Cross-sectional study. The right eyes of 16 healthy participants and 13 RP patients. Pupil responses to red and blue light (peak, 485 and 625 nm, respectively) presented by 76 light-emitting diodes, 1.8-mm spot size at different locations of a 16.2° VF were recorded. Subjective VFs of RP patients were determined using chromatic dark-adapted Goldmann VFs (CDA-GVFs). Six healthy participants underwent 2 pupillometer examinations to determine test-retest reliability. Three parameters of pupil contraction were determined automatically: percentage of change of pupil size (PPC), maximum contraction velocity (MCV; in pixels per second), and latency of MCV (LMCV; in seconds). The fraction of functional VF was determined by CDA-GVF. In healthy participants, higher PPC and MCV were measured in response to blue compared with red light. The LMCV in response to blue light was relatively constant throughout the VF. Healthy participants demonstrated higher PPC and MCV and shorter LMCV in central compared with peripheral test points in response to red light. Test-retest correlation coefficients were 0.7 for PPC and 0.5 for MCV. In RP patients, test point in which the PPC and MCV were lower than 4 standard errors from the mean of healthy participants correlated with areas that were indicated as nonseeing by CDA-GVF. The mean absolute deviation in LMCV parameter in response to the red light between different test point was significantly higher in RP patients (range, 0.16-0.47) than in healthy participants (range, 0.02-0.16; P chromatic multifocal pupillometer for objective diagnosis of RP and assessment of VF defects. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  19. 7-Hexagon Multifocal Electroretinography for an Objective Functional Assessment of the Macula in 14 Seconds.

    Science.gov (United States)

    Schönbach, Etienne M; Chaikitmongkol, Voraporn; Annam, Rachel; McDonnell, Emma C; Wolfson, Yulia; Fletcher, Emily; Scholl, Hendrik P N

    2017-01-01

    We present the multifocal electroretinogram (mfERG) with a 7-hexagon array as an objective test of macular function that can be recorded in 14 s. We provide normal values and investigate its reproducibility and validity. Healthy participants underwent mfERG testing according to International Society for Clinical Electrophysiology of Vision (ISCEV) standards using the Espion Profile/D310 multifocal ERG system (Diagnosys, LLC, Lowell, MA, USA). One standard recording of a 61-hexagon array and 2 repeated recordings of a custom 7-hexagon array were obtained. A total of 13 subjects (mean age 46.9 years) were included. The median response densities were 12.5 nV/deg2 in the center and 5.2 nV/deg2 in the periphery. Intereye correlations were strong in both the center (ρCenter = 0.821; p < 0.0001) and the periphery (ρPeriphery = 0.862; p < 0.0001). Intraeye correlations were even stronger: ρCenter = 0.904 with p < 0.0001 and ρPeriphery = 0.955 with p < 0.0001. Bland-Altman plots demonstrated an acceptable retest mean difference in both the center and periphery, and narrow limits of agreement. We found strong correlations of the center (ρCenter = 0.826; p < 0.0001) and periphery (ρPeriphery = 0.848; p < 0.0001), with recordings obtained by the 61-hexagon method. The 7-hexagon mfERG provides reproducible results in agreement with results obtained according to the ISCEV standard. © 2017 S. Karger AG, Basel.

  20. Crianças usuárias de lente de contato nos serviços público e privado: análise comparativa Pediatric contact lens users in public and private services: comparative analysis

    Directory of Open Access Journals (Sweden)

    Daniela Araújo Toscano

    2009-04-01

    Full Text Available OBJETIVOS: Analisar as indicações, tipo, complicações do uso de lentes de contato e acuidade visual em crianças de serviços de Oftalmologia público e privado. MÉTODOS: Os dados dos prontuários de 59 crianças usuárias de lentes de contato em serviço privado (Hospital de Olhos de Pernambuco - Grupo 1, e 43 no serviço público (Fundação Altino Ventura - Grupo 2, foram analisados. A coleta de dados incluiu características sociodemográficas, idade da primeira consulta, indicação do uso da lente, tipo de lente, complicações e acuidade visual. RESULTADOS: As mais comuns indicações do uso de lente de contato no grupo 1 foram: ametropia (55,9%, anisometropia (18,6% e esotropia (16,9%. Neste grupo o leucoma e phthisis não estavam presentes. No grupo 2, as indicações mais comuns foram: anisometropia (23,2%, ametropia e leucoma (18,6% cada, e phthisis (16,3%. A esotropia não apareceu no grupo 2. O tipo de lente de contato mais prescrita foi a gelatinosa de uso permanente (não descartável no grupo 1 (45,8% e no grupo 2 (32,6%. A complicação mais encontrada no grupo 1 foi desconforto (33,3% e no grupo 2 perda da lente (60%. CONCLUSÕES: A indicação de ametropia predominou nos pacientes privados e as anisometropias nos públicos. O tipo de lente de contato mais prescrita nos dois grupos foi a gelatinosa de uso permanente. A complicação mais frequente no grupo 1 foi desconforto e no grupo 2 perda da lente. A acuidade visual na maioria dos pacientes manteve-se.PURPOSE: To analyze the indications, type and complications of contact lens use and visual acuity in children, in ophthalmological, public and private, services. METHODS: The information from the medical records of 59 contact lens users at a private service (Hospital de Olhos de Pernambuco - Recife - PE- Brazil - group 1, and 43 at public service (Fundação Altino Ventura - Recife - PE - Brazil - group 2, was analyzed. The collected data included: demographic information

  1. Espectrofotometria de lentes oftálmicas filtrantes coloridas sob radiação ultravioleta a e luz visível Spectrophotometry of ophthalmic filtering color lenses under ultraviolet radiation and visible light

    Directory of Open Access Journals (Sweden)

    Luís Felipe Fornaciari Ramos

    2003-06-01

    Full Text Available OBJETIVO: Determinar a transmitância das lentes oftálmicas filtrantes coloridas submetidas à radiação UV A e luz visível e comparar seus resultados na faixa de comprimento de onda compreendida entre 320 e 800 nanômetros (nm. MÉTODOS: Análise espectrofotométrica das lentes filtrantes amarela 1, laranja, verde e fumê da marca "Danny" e amarela 2 da marca "Rio de Janeiro", disponíveis em nosso meio, utilizando-se espectrofotômetro Modelo 6.400, marca JEM Way. RESULTADOS: Todas as lentes estudadas apresentaram padrões de transmitância bastante individualizados, com curvas variáveis para os diversos comprimentos de onda. Na faixa es- pectrofotométrica de 320 a 400 nm, todas as lentes apresentaram transmitância inferior a 4% sendo que a lente amarela 1 apresentou a maior média (3,7 % ao passo que a fumê apresentou a menor média 0,45%. Contudo não foi observado uma diferença estatisticamente significativa entre estas lentes; a lente amarela 2 mostrou melhor proteção em comparação à lente amarela 1 e a laranja. Na análise espectrofotométrica realizada em diferentes posições da mesma lente constatou-se diversidade na curva de variância, apesar de não demonstrar diferença estatisticamente significativa. CONCLUSÕES: Para se indicar um filtro com segurança, as propriedades espectrais do filtro devem ser determinadas pela análise espectrofotométrica. É mais importante a capacidade de filtrar radiações luminosas do que somente ser colorido ou não.PURPOSE: Determination of transmittance curves through spetrophotometric measurementes of color filtering lenses submitted to UVA and light visible radiation, and comparison of the results in the band between 320 and 800 nanometres (nm. METHODS: The filtering color of Danny yellow 1, orange, green and grey and Rio de Janeiro yellow 2 lenses have been analyzed using JEM Way model 6.400 spectrophotometer. RESULTS: All lenses showed distinct and variable transmittance in the

  2. Lente de contato de material híbrido em pacientes com ceratocone e astigmatismo miópico composto Hybrid material contact lens in keratoconus and myopic astigmatism patients

    Directory of Open Access Journals (Sweden)

    Fernando Leal

    2007-03-01

    Full Text Available OBJETIVOS: Avaliar o desempenho visual e o conforto de lentes de contato de material híbrido, quanto ao apresentado por pacientes portadores de ceratocone e astigmatismo miópico composto, e comparar com a lente de contato rígida-gás-permeável nos dois grupos de pacientes. MÉTODOS: Foram submetidos à adaptação com lentes de contato 22 pacientes, sendo 8 portadores de astigmatismo miópico composto e 14 com diagnóstico de ceratocone. Entre os pacientes, 7 eram do sexo masculino e 15 do feminino, com idade média de 32,13 anos ± 8,12. Cada paciente recebeu uma lente de contato de material híbrido e, no contralateral, uma lente rígida-gás-permeável. A escolha da lente a ser adaptada no olho direito ou esquerdo foi feita aleatoriamente, sendo o trabalho duplo-mascarado. Os pacientes foram submetidos aos seguintes exames: medida do conforto por meio da escala visual analógica, tempo de ruptura do filme lacrimal, acuidade visual pela escala de Bailey-Lovie adaptada para quatro metros, sensibilidade ao contraste pelo "functional acuity contrast test" e análise das aberrações oculares pela análise de frentes de onda. RESULTADOS: Com relação ao conforto não houve associação com o tipo de lente (p=0,350. Houve variação no conforto referido ao longo do tempo até 7 dias (p=0,001, estabilizando-se após este período. A medida da acuidade visual sofreu aumento entre a adaptação e a medida obtida aos 7 dias, bem como desta para a medida de 15 dias, estabilizando-se então. A acuidade visual não apresentou diferenças com relação ao tipo de lente estudada. Verificou-se que não houve diferença no tempo de ruptura do filme lacrimal (p=0,989 com relação aos tipos de lentes, porém houve diminuição deste (p=0,001 quando comparadas as medidas antes do início do uso das lentes e com dois meses de uso. Os tipos de lentes não revelaram associação com a sensibilidade ao contraste e não diferiram das medidas feitas com o uso de

  3. Facoemulsificación e implante de lente intraocular en cataratas causadas por uveitis Phacoemulsification and intraocular lens implantation in patients with cataract caused by uveitis

    Directory of Open Access Journals (Sweden)

    Dayamí Pérez Gómez

    2008-06-01

    Full Text Available OBJETIVO: Evaluar los resultados de la facoemulsificación y el implante de lente intraocular en cataratas causadas por uveítis. MÉTODOS: Se estudiaron 37 ojos con 6 meses de inactividad inflamatoria, agudeza visual menor de 0,6 y edad media de 47 años. Se excluyeron otras enfermedades que disminuyeran la visión. En el preoperatorio se prescribió antiinflamatorios. Se realizó la facoemulsificación con implante de lente intarocular (PMMA, óptica 6 mm; durante el seguimiento desde 24 h/6 meses se indicó antiinflamatorios esteroideos, no esteroideos e inmunosupresores hasta 6 semanas. RESULTADOS: Se observaron numerosas alteraciones del segmento anterior secundarias a las uveítis padecidas (posquirúrgicas, inespecíficas, ciclítis heterocrómica de Fuchs, postraumáticas, síndrome de Reiter, por toxoplasmosis y otras coroiditis infecciosas y por artritis reumatoide juvenil. No hubo recurrencia posquirúrgica de la uveítis en 9 ojos (24,3 %. Las complicaciones estuvieron relacionadas con la uveítis, la cirugía, la actividad inflamatoria, y la reacción del epitelio capsular. La opacidad capsular posterior apareció en 11 pacientes (29,7 % asociada a edad joven. La evolución individual se consideró satisfactoria en 30 (81,1 % pacientes con mejoría de la visión hasta 0,8-1,0 en 28 (75,6 % y 0,5-0,6 en 2 (5,4 %. CONCLUSIONES: La facoemulsificación con implante de lente intarocular es de gran utilidad en las cataratas posuveítis al condicionar poca agresión quirúrgica, ser controlable la inflamación y proporcionar buenos resultados visuales además del reordenamiento anatomofisiológico del segmento anterior.OBJECTIVE: To assess the results of phacoemulsification and intraocular lens implantation in cataracts caused by uveitis. METHODS: Thirty seven eyes with no inflammation for 6 months, visual acuity below 0.6 and average age of 47 years were studied. Other diseases affecting the vision were excluded. The preoperative

  4. Fission ionisation chamber for the measurement of low fluxes of slow neutrons; Chambre d'ionisation a fission pour la mesure des faibles flux de neutrons lents

    Energy Technology Data Exchange (ETDEWEB)

    Weill, J; Duchene, J P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1958-07-01

    The ionisation chamber described is designed for the measurement of slow neutron fluxes of average or low intensity, in the presence, eventually, of very high gamma fluxes. The capture of a slow neutron by a fissile material, in this case {sup 235}U, gives rise to fission fragments, high-energy particles which ionise the gas contained in the chamber. The neutrons are detected by virtue of the potential pulses, on the collecting electrode of the chamber, deriving from the collection of the ions produced by the fission fragments. The pulses are counted by means of a measuring system consisting of a preamplifier, a 2 Mc amplifier, a discriminator and an electronic scale with numerator or integrator. The general characteristics are as follows: sensitivity to neutrons: 0.07 kicks/n/cm{sup 2}.s, sensitivity to {gamma} rays: zero up to 3.10{sup 4} R/H, a background noise at the normal discrimination voltage: 0.01 kicks/s, working H.T.: -500 V, capacity: 40 {mu}{mu}F, average height of pulse: 8 mV, limits of use: from several neutrons to 10{sup 6} n/cm{sup 2}.s. This chamber may be used in all cases where low fluxes of slow neutrons must be measured, especially in the presence of high gamma fluxes, for example in the checking of Pu concentrations in an extraction plant or for the starting up of reactors. (author) [French] La chambre d'ionisation decrite est destinee a la mesure des flux de neutrons lents d'intensite moyenne ou faible, en presence eventuelle de flux gamma tres importants. La capture d'un neutron lent par un materiau fissile, en l'occurrence {sup 235}U, donne naissance a des fragments de fission, particules de grande energie qui ionisent le gaz contenu dans la chambre. Les neutrons sont detectes grace aux impulsions de potentiel, sur l'electrode collectrice de la chambre, provenant de la collection des ions produits par les fragments de fission. Une chaine de mesure comprenant un preamplificateur, un amplificateur 2 Mc, un discriminateur, une echelle

  5. Experiments on the thermalization of slow neutrons by liquid hydrogen (1962); Experience de thermalisation de neutrons lents par de l'hydrogene liquide (1962)

    Energy Technology Data Exchange (ETDEWEB)

    Cribier, D; Jacrot, B; Lacaze, A; Roubeau, P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Institut Fourier, 38 - Grenoble (France)

    1962-07-01

    In order to increase the flux of neutrons of long wave-length ({lambda} > 4 A) emerging from a channel in the EL-3, a liquid hydrogen device was introduced into a channel of the reactor (Channel H{sub 1}). The principle of the device is simple. A volume of liquid hydrogen is introduced as close as possible to the reactor core into a region of intense isotropic flux. This hydrogen slows down the slow neutrons; because of the very small mean free diffusion path of slow in hydrogen, this slowing down is considerable even in a small volume of liquid hydrogen, and the spectrum temperature of neutrons emerging from the volume of liquid hydrogen can therefore be shifted. The intensity gain for neutrons with a wave length {lambda}, is a G ({lambda}) function which, for perfect thermalization and ignoring capture, is expressed by: G ({lambda}) = 225 exp (- 45.3/{lambda}{sup 2}), assuming a temperature of 300 deg. K for the neutrons before cooling and is 20 deg. K after cooling. For a wave-length of 5 A, the theoretical maximum gain of thus about 37. (authors) [French] Dans le but d'accroitre le flux des neutrons de grande longueur d'onde ({lambda} > 4 A) sortant d'un canal de la pile EL-3, un dispositif a hydrogene liquide a ete introduit dans un canal de la pile (canal H{sub 1}). Le principe du dispositif est simple. Un volume d'hydrogene liquide est introduit le plus pres possible du coeur de ia pile dans une region de flux intense et isotrope. Les neutrons lents sont ralentis par cet hydrogene; a cause du tres faible libre parcours moyen de diffusion des neutrons lents dans l'hydrogene, ce ralentissement est important meme dans un faible volume d'hydrogene liquide et l'on peut ainsi deplacer la temperature du spectre des neutrons sortant du volume d'hydrogene liquide. Le gain en intensite des neutrons de longueur d'onde {lambda} est une fonction G ({lambda}) qui pour une thermalisation parfaite et en negligeant la capture, s'exprime par: G ({lambda}) = 225 exp (- 45

  6. Multifocal epilepsy: the role of palliative resection - intractable frontal and occipital lobe epilepsy secondary to radiotherapy for acute lymphoblastic leukaemia.

    Science.gov (United States)

    Radhakrishnan, Ashalatha; Sithinamsuwan, Pasiri; Harvey, A Simon; Flanagan, Danny; Fitt, Gregory; Berlangieri, Sam; Jackson, Graeme D; Berkovic, Samuel F; Scheffer, Ingrid E

    2008-12-01

    Patients with multifocal epilepsy are often considered unsuitable for epilepsy surgery. We report an adolescent with intractable frontal and occipital lobe seizures, secondary to complications of treatment for acute lymphoblastic leukaemia as a young child. Chemotherapy and radiotherapy were complicated by bilateral, posterior leukoencephalopathy and later an acquired frontal cerebral cavernous malformation (CCM). Detailed electro-clinical and imaging studies showed multiple, frontal lobe seizures per day with less frequent and non-debilitating, simple, occipital lobe seizures. Focal resection of the frontal CCM abolished the socially-disabling seizures with resultant marked improvement in the patient's quality of life at 12 months. Careful analysis of the type and impact of focal seizures in the setting of multifocal epilepsy may demonstrate that one seizure type is more deleterious to quality of life and may be amenable to surgery. In this situation, the patient may benefit significantly from surgery to resect the more active epileptic focus.

  7. Early Magnetic Resonance Detection of Natalizumab-Related Progressive Multifocal Leukoencephalopathy in a Patient with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Guglielmo Manenti

    2013-01-01

    Full Text Available Diagnosis of progressive multifocal leukoencephalopathy is usually based on the clinical presentation, on the demonstration of the brain lesions at the magnetic resonance imaging examination, and on the detection of the JC virus DNA in the cerebrospinal fluid with high sensitive polymerase chain reaction. The role of magnetic resonance imaging specifically in natalizumab-associated progressive multifocal leukoencephalopathy is strengthening, and it is gaining importance not only as an irreplaceable diagnostic tool but also as a surveillance and risk stratifying tool in treated patients. While other imaging techniques such as computed tomography lack sensitivity and specificity, magnetic resonance performed with morphological and functional sequences offers clinicians the possibility to early identify the stage of the disease and the emergence of an immune reconstitution inflammatory syndrome after natalizumab blood removal plasmapheresis.

  8. The effect of dimethyl fumarate (Tecfidera™) on lymphocyte counts: A potential contributor to progressive multifocal leukoencephalopathy risk.

    Science.gov (United States)

    Khatri, Bhupendra O; Garland, Jeffery; Berger, Joseph; Kramer, John; Sershon, Lisa; Olapo, Tayo; Sesing, Jean; Dukic, Mary; Rehn, Eileen

    2015-07-01

    Dimethyl fumarate (Tecfidera™) is an effective therapy for relapsing forms of multiple sclerosis (MS). Our study suggests that this drug may have immunosuppressive properties evidenced by significant sustained reduction in CD8 lymphocyte counts and, to a lesser extent, CD4 lymphocyte counts. This observation is relevant in light of the recent case of progressive multifocal leukoencephalopathy in a patient receiving this drug. Copyright © 2015. Published by Elsevier B.V.

  9. Multifocal Gastric Ulcers Caused by Diffuse Large B Cell Lymphoma in a Patient With Significant Weight Loss

    OpenAIRE

    Gromski, Mark A.; Peng, Jennifer L.; Zhou, Jiehao; Masuoka, Howard C.; Suvannasankha, Attaya; Liangpunsakul, Suthat

    2016-01-01

    Primary gastrointestinal (GI) lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL) who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endosco...

  10. Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses.

    Science.gov (United States)

    Brito, Pedro; Salgado-Borges, José; Neves, Helena; Gonzalez-Meijome, José; Monteiro, Manuel

    2015-03-01

    To study the perception of light distortion after refractive lens exchange (RLE) with diffractive multifocal intraocular lenses (IOLs). Clínica Oftalmológica das Antas, Porto, Portugal. Retrospective comparative study. Refractive lens exchange was performed with implantation of an AT Lisa 839M (trifocal) or 909MP (bifocal toric) IOL, the latter if corneal astigmatism was more than 0.75 diopter (D). The postoperative visual and refractive outcomes were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. A control group of eyes in which a Tecnis ZCB00 1-piece monofocal IOL was implanted had the same examinations. A trifocal or bifocal toric IOL was implanted in 66 eyes. The control IOL was implanted in 18 eyes. All 3 groups obtained a significant improvement in uncorrected distance visual acuity (UDVA) (P refractive cylinder was less than 1.00 D in 86.7% of cases with the toric IOL. The mean light-distortion index was significantly higher in the multifocal IOL groups than in the monofocal group (P light-distortion index and CDVA. The multifocal IOLs provided excellent UDVA and functional UNVA despite increased light-distortion indices. The light-distortion analyzer reliably quantified a subjective component of vision distinct from visual acuity; it may become a useful adjunct in the evaluation of visual quality obtained with multifocal IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Evaluation of Optical Quality: Ocular Scattering and Aberrations in Eyes Implanted with Diffractive Multifocal or Monofocal Intraocular Lenses.

    Science.gov (United States)

    Liao, Xuan; Lin, Jia; Tian, Jing; Wen, BaiWei; Tan, QingQing; Lan, ChangJun

    2018-06-01

    To compare objective optical quality, ocular scattering and aberrations of eyes implanted with an aspheric monofocal intraocular lens (IOL) or an aspheric apodized diffractive multifocal IOL three months after surgery. Prospective consecutive nonrandomized comparative cohort study. A total of 80 eyes from 57 cataract patients were bilaterally or unilaterally implanted with monofocal (AcrySof IQ SN60WF) or multifocal (AcrySof IQ ReSTOR SN6AD1) IOLs. Respectively, 40 eyes of 27 patients were implanted with monofocal IOLs, and 40 eyes of 30 patients were implanted with multifocal IOLs. Ocular high-order aberration (HOA) values were obtained using Hartmann-Shack aberrometer; objective scatter index (OSI), modulation transfer function (MTF) cutoff, Strehl ratio (SR), and contrast visual acuity OV at 100%, 20%, and 9% were measured using Objective Quality Analysis System II (OQAS II). Ocular aberrations performed similar in both groups (p > 0.05). However, significantly higher values of OSI and lower values of MTF cutoff, SR and OV were found in the SN6AD1 group (p < 0.05). Both ocular scattering and wave-front aberrations play essential role in retinal image quality, which may be overestimated when only aberrations were taken into account. Combining the effect of ocular scattering with HOA will result in a more accurate assessment of the visual and optical quality.

  12. Confirmação do cálculo de lente intraocular através da refração intraoperatória

    Directory of Open Access Journals (Sweden)

    Ana Luiza Biancardi

    2011-04-01

    Full Text Available Este relato descreve a utilização do método refracional intraoperatório para confirmação do cálculo da lente intraocular (LIO. Paciente de 67 anos com acuidade visual (AV igual a 20/60 no olho esquerdo (OE com correção igual a -21,50 esf -400 cil a 170 devido à LIO de silicone 3 peças impregnada por óleo de silicone. Foi indicada a troca da LIO, porém as medidas biométricas pré-operatórias eram variáveis e não confiáveis. Foi realizado o cálculo intraoperatório e o paciente foi submetido à troca da LIO impregnada por uma LIO acrílica 3 peças. O paciente atingiu AV no OE igual a 20/30 com correção igual a -125 esf -1,25 cil a 180. A análise da LIO explantada confirmou a impregnação por óleo de silicone. O cálculo refracional intraoperatório é muito importante para confirmação do valor da LIO.

  13. Desempenho visual de lentes de contato gelatinosas de diferentes tipos baseado na análise de frentes de onda Optical performance of different soft contact lenses based on wavefront analysis

    Directory of Open Access Journals (Sweden)

    Roberta Fagnani Gatti

    2008-12-01

    Full Text Available OBJETIVOS: Avaliar e comparar o desempenho visual, por meio da análise de frentes de onda, de seis diferentes tipos de lentes de contato gelatinosas [Cooperflex® (Coopervision, Frequency® 55 Aspheric (Coopervision, World Vision FW® (World Vision, Pure Vision® (Bausch & Lomb, Focus® Monthly (Ciba Vision, Focus® Choice AB (Ciba Vision]. MÉTODOS: Realizou-se estudo prospectivo em amostra constituída por 130 olhos de 71 indivíduos portadores de miopia ou hipermetropia até 6,00D e astigmatismo até 1,50D, com acuidade visual corrigida com óculos igual ou superior a 20/20. Os sujeitos foram inicialmente submetidos ao exame clínico oftalmológico e posteriormente, ao exame de análise de frentes de onda com o aberrômetro LADARWave® (Alcon, em duas condições: sem correção óptica e em uso de um dos tipos de lente de contato incluídos no estudo, com grau correspondente ao equivalente esférico do paciente e corrigido pela distância vértice. Para análise de resultados os indivíduos foram divididos em seis grupos similares, sendo testado em cada grupo um dos tipos de lente incluídos no estudo. RESULTADOS: Mudanças nos valores das aberrações de alta ordem foram verificadas durante uso das lentes de contato. De 130 olhos estudados, 78 apresentaram aumento no valor de RMS total durante o uso da lente. Os seis tipos de lente estudados demonstraram tendência ao aumento no valor médio de RMS total durante seu uso, sem diferença estatisticamente significante entre as mesmas. O estudo demonstrou tendência ao aumento no valor médio das aberrações tipo "coma" durante o uso das lentes. As lentes Frequency® Aspheric e Cooperflex® apresentaram melhor desempenho visual em relação ao "coma". O estudo demonstrou tendência à diminuição no valor médio das aberrações esféricas durante o uso das lentes, sendo esta tendência maior nos pacientes míopes em relação aos hipermétropes. Foi demonstrado tendência ao aumento no

  14. Complicación poco frecuente del uso de lentes de contacto duros: Presentación de 1 caso Rare complications of the use of hard contact lens: A case report

    Directory of Open Access Journals (Sweden)

    Elizabeth Escalona Leyva

    2003-12-01

    Full Text Available Se presentó una rara complicación con el uso de lentes de contacto duros en una paciente femenina de 45 años de edad, con antecedentes de 15 años de uso que acudió a la consulta por pérdida de sus lentes de contacto de 15 días de evolución. Se detectó aumento de volumen, doloroso en el párpado superior izquierdo donde se encontró en su eversión el lente "sembrado" en el tarso con granuloma que lo envuelve. Se presentan los hallazgos clínicos y la evolución.A rare complication of the use of hard contact lenses. A case report A rare complication with the use of hard contact lenses was observed in a 45-year-old female patient who had worn them during 15 years and visited the physician's office 15 days after losing her contact lenses. It was observed increase of volume, painful in the left upper eyelid, where it was found in its eversion the lens "planted" in the tarsus with a granuloma covering it. The clinical findings and evolution are presented.

  15. Mitoxantrone Therapy for Acute Posterior Multifocal Placoid Pigment Epitheliopathy with Cerebral Vasculitis

    Directory of Open Access Journals (Sweden)

    Hélène Massé

    2009-01-01

    Full Text Available Purpose. To report favorable outcome of a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE associated with cerebral vasculitis after treatment with immunosuppressive therapy by mitoxantrone. Design. Single case report. Method. A 22-year-old man presented with acute isolated bilateral loss of vision revealing APMPPE. Corticosteroid therapy was initiated and visual acuity gradually improved. Seventeen days later, visual function deteriorated again, associated with flu-like syndrome and severe headaches. A relapse of APMPPE was diagnosed, complicated with lymphocytic meningitis and cerebral ischemia. Intravenous therapy with mitoxantrone was performed in combination with methylprednisolone. Results. Headaches disappeared in a few days whereas visual acuity gradually improved and stabilized at 20/40 in the right eye and 20/32 in the left eye. No adverse event was observed. Clinical improvement was confirmed by magnetic resonance imaging. Conclusion. Cerebral vasculitis is the most severe complication of the extraocular manifestations of APMPEE. This diagnosis should be evoked when severe headaches or behavior disorder are associated with APMPEE.

  16. CT and MRI in progressive multifocal leukoencephalopathy. CT und MRT der progressiven multifokalen Leukenzephalopathie (PML)

    Energy Technology Data Exchange (ETDEWEB)

    Lanfermann, H. (Inst. und Poliklinik fuer Radiologische Diagnostik, Koeln Univ. (Germany)); Heindel, W. (Inst. und Poliklinik fuer Radiologische Diagnostik, Koeln Univ. (Germany)); Schroeder, R. (Neuropathologie des Inst. fuer Pathologie, Koeln Univ. (Germany)); Lackner, K. (Inst. und Poliklinik fuer Radiologische Diagnostik, Koeln Univ. (Germany))

    1994-07-01

    Radiological findings and course of progressive multifocal leukoencephalopathy in 14 patients (1 woman, 13 men; 13 HIV seropositive, 1 chronic lymphatic leukaemia) were analysed retrospectively and correlated with clinical symptoms. A total of 21 CT and 16 MRI studies were evaluated. CT scans and MR images of 9 patients, which had been obtained in less than two weeks, could be compared to each other. MRI was superior to CT: 6 lesions with a diameter of 1 cm and below were not detected on CT scans, in 5 patients the extent of lesions was underestimated. Cortical involvement, mass effect or signs of atrophy were missing. Only 1 of 65 lesions showed a tiny enhancement after Gd injection. Due to the pattern and spread of lesions, which showed a close correlation to the neurologic symptoms, three different types of PML are suggested: 1. Initial precentral demyelinisation with contralateral hemiparesis (n=8); 2. lesions in temporo-occipital locations with visual disturbances (n=2); 3. predominantly bilateral lesions of cerebellar white matter with ataxia (n=4). (orig.)

  17. Recurrent multifocal chronic osteitis in children; Osteite chronique multifocale recurrente de l`enfant

    Energy Technology Data Exchange (ETDEWEB)

    Quelquejay, C.; Hamidou, A.; Benosman, A.; Adamsbaum, C. [Hopital Saint-Vincent-de-Paul, 75 - Paris (France); Job-Deslandre, Ch. [Hopital Cochin, 75 - Paris (France)

    1997-09-01

    We have studied retrospectively a series of 10 children presenting with chronic multifocal osteomyelitis (8 girls, 2 boys, 7 to 16 years). All patients had plain films, bone scintigraphies and histological studies. Three had CT scan and/or MRI. Compared with literature data, we observed only one case of palmo-plantar pustulosis and only 2 cases of lysis of the medial extremity of the clavicle; in addition, we report one case of lateral extremity of the clavicle and 2 vertebral locations. The radiological pattern was typical: at the beginning of the disease, plain films showed lytic areas which became progressively osteosclerotic with enlargement of the bone. In all the cases, bone scintigraphy revealed high uptake areas which were often infra-clinical. The diagnosis was delayed from 3 months to 3 years. This emphasizes the difficulty of the diagnosis which relies on the association of clinical, biological and radiological elements. Biopsies are required to rule out an infectious bacterial osteomyelitis or a tumoral process. The pathogenesis of OCMR remains unknown, but the relation with the SAPHO (synovitis, acne, pustulosis, Hyperostosis, osteitis) syndrome is general accepted because of the similar features of the osteitis. The long term follow up appears to be uncertain: 6 of our patients are still symptomatic after five years despite anti inflammatory treatment. (authors). 22 refs.

  18. Multifocal pancreatic serous cystadenoma with atypical cells and focal perineural invasion.

    Science.gov (United States)

    Kamei, K; Funabiki, T; Ochiai, M; Amano, H; Kasahara, M; Sakamoto, T

    1991-10-01

    A case of multifocal pancreatic serous cystadenoma with atypical cells is reported. The patient was a 72-yr-old female who complained of jaundice. The distal common bile duct was obstructed, and the proximal bile duct was remarkably dilated on cholangiography. The main portal vein was obstructed and collateral vessels had developed on portal angiography. Total pancreatectomy was performed. The resected specimen contained one tumor in the head of the pancreas, five in the body, and one in the tail. The tumors of the head and body were morphologically the same. Microscopically, both contained spongelike multilocular cysts on their cut surfaces. These cysts were covered with low cuboid epithelium containing clear cytoplasm and abundant glycogen. Neural invasion was also found. The tumor cells exhibited an increased N/C ratio, variable nuclear size, irregular nuclear margins, and coarse nuclear chromatin. These tumors had aneuploid nuclear DNA with a DNA index of 1.9 and a proliferation index of 0.28. We feel that it is necessary to reconsider the biological concept of serous cystadenoma.

  19. Clinical application of multifocal visual evoked potentials in children with epilepsy caused by intracranial disease

    International Nuclear Information System (INIS)

    Yukawa, Eiichi; Kim, Yeong-Jin; Kawasaki, Kensuke; Yoshii, Toshiaki; Hara, Yoshiaki

    2006-01-01

    We investigated whether visual field defects could be objectively evaluated using multifocal visual evoked potential (m-VEP) in two children with epilepsy caused by intracranial disease in whom it was difficult to measure the visual field. To determine normal waves in m-VEP, recording was performed using a visual evoked response imaging system (VERIS) Junior Science program (Mayo, Aichi, Japan) in 20 healthy children (20 eyes) peak latency and amplitude were used for assessment. In the two children with epilepsy, m-VEPs were recorded, and compared with the results of static perimetry or the lesions observed by Magnetic Resonance Imaging (MRI). In the 20 healthy children, there was no significant difference in the peak latency or amplitude among 4 quadrants by one-way analysis of variance. m-VEP in the children with epilepsy showed abnormal waves, corresponding to the visual field defects in the static perimetry or the lesions observed by MRI. Objective evaluation of visual field defects using m-VEP may be useful in children with epilepsy caused by intracranial disease in whom kinetic/static perimetry as a subjective examination is difficult. (author)

  20. [Influence of different multifocal intraocular lens concepts on retinal stray light parameters].

    Science.gov (United States)

    Ehmer, A; Rabsilber, T M; Mannsfeld, A; Sanchez, M J; Holzer, M P; Auffarth, G U

    2011-10-01

    Multifocal intraocular lenses (MIOL) are known to induce various photic phenomena depending on the optical principle. The aim of this study was to investigate the correlation between stray light measurements performed with the C-Quant (Oculus, Germany) and the results of a subjective patient questionnaire. In this study three different MIOLs were compared: AMO ReZoom (refractive design, n=10), AMO ZM900 (diffractive design, n=10) and Oculentis Mplus (near segment design, n=10). Cataract and refractive patients were enrolled in the study. Functional results were evaluated at least 3 months postoperatively followed by stray light measurements and a subjective questionnaire. Surgery was performed for all patients without complications. The three groups were matched for age, IOL power and corrected distance visual acuity (CDVA). Significantly different stray light (median) values log(s) were found (Kruskal-Wallis test, p<0.05): 1.12 log (refractive), 1.13 log (segment) and 1.28 log (diffractive). The subjective questionnaire did not show differences in glare perception but refractive MIOL patients noticed more halos surrounding light sources than the diffractive and segment MIOL patients. Stray light and subjective photopic phenomena do not show any basic correlation. Measurements in patients with refractive MIOLs showed less stray light than near segment or diffractive MIOLs. However, refractive MIOLs induced more halos compared to the other groups analyzed.

  1. Image quality comparison of two multifocal IOLs: influence of the pupil.

    Science.gov (United States)

    García-Domene, Mari Carmen; Felipe, Adelina; Peris-Martínez, Cristina; Navea, Amparo; Artigas, Jose M; Pons, Álvaro M

    2015-04-01

    To evaluate the effect of pupil size on image quality of a sectorial multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), and the Acri.LISA IOL (Carl Zeiss Meditec, Jena, Germany). The authors measured the MTFs of the Lentis Mplus LS-312 IOL and the Acri.LISA 366D IOL with three different sizes of pupil diameters: 3, 4, and 5 mm. The MTF was calculated from the cross-line spread function recorded with the OPAL Vector System (Image Science Ltd., Oxford, UK) by using fast Fourier-transform techniques. In distance focus, the image quality provided by the Lentis Mplus IOL was better than that of the Acri. LISA IOL with all pupil diameters. In near focus, the MTF of the Acri.LISA IOL was better with a 3-mm pupil, but poor with larger pupils. The aberration effect was equal in both IOLs in distance focus, but in near focus and with a 3-mm pupil, the Acri.LISA IOL was less affected by the aberration than the Lentis Mplus IOL. The Lentis Mplus IOL provides better distance image quality than the Acri.LISA IOL, whereas the near image quality of the Acri.LISA IOL is better with small-pupil diameter. The sectorial design makes this IOL more suitable for patients with a pupil diameter greater than 3 mm. Copyright 2015, SLACK Incorporated.

  2. Non-descanned multifocal multiphoton microscopy with a multianode photomultiplier tube

    International Nuclear Information System (INIS)

    Cha, Jae Won; Yew, Elijah Y. S.; Kim, Daekeun; Subramanian, Jaichandar; Nedivi, Elly; So, Peter T. C.

    2015-01-01

    Multifocal multiphoton microscopy (MMM) improves imaging speed over a point scanning approach by parallelizing the excitation process. Early versions of MMM relied on imaging detectors to record emission signals from multiple foci simultaneously. For many turbid biological specimens, the scattering of emission photons results in blurred images and degrades the signal-to-noise ratio (SNR). We have recently demonstrated that a multianode photomultiplier tube (MAPMT) placed in a descanned configuration can effectively collect scattered emission photons from each focus into their corresponding anodes significantly improving image SNR for highly scattering specimens. Unfortunately, a descanned MMM has a longer detection path resulting in substantial emission photon loss. Optical design constraints in a descanned geometry further results in significant optical aberrations especially for large field-of-view (FOV), high NA objectives. Here, we introduce a non-descanned MMM based on MAPMT that substantially overcomes most of these drawbacks. We show that we improve signal efficiency up to fourfold with limited image SNR degradation due to scattered emission photons. The excitation foci can also be spaced wider to cover the full FOV of the objective with minimal aberrations. The performance of this system is demonstrated by imaging interneuron morphological structures deep in the brains of living mice

  3. Non-descanned multifocal multiphoton microscopy with a multianode photomultiplier tube

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Jae Won; Yew, Elijah Y. S. [Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA (United States); Kim, Daekeun [Department of Mechanical Engineering, Dankook University (Korea, Republic of); Subramanian, Jaichandar [Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA (United States); Nedivi, Elly [Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA (United States); Departments of Brain and Cognitive Sciences, and Biology, Massachusetts Institute of Technology, Cambridge, MA (United States); So, Peter T. C. [Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA (United States); Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA (United States)

    2015-08-15

    Multifocal multiphoton microscopy (MMM) improves imaging speed over a point scanning approach by parallelizing the excitation process. Early versions of MMM relied on imaging detectors to record emission signals from multiple foci simultaneously. For many turbid biological specimens, the scattering of emission photons results in blurred images and degrades the signal-to-noise ratio (SNR). We have recently demonstrated that a multianode photomultiplier tube (MAPMT) placed in a descanned configuration can effectively collect scattered emission photons from each focus into their corresponding anodes significantly improving image SNR for highly scattering specimens. Unfortunately, a descanned MMM has a longer detection path resulting in substantial emission photon loss. Optical design constraints in a descanned geometry further results in significant optical aberrations especially for large field-of-view (FOV), high NA objectives. Here, we introduce a non-descanned MMM based on MAPMT that substantially overcomes most of these drawbacks. We show that we improve signal efficiency up to fourfold with limited image SNR degradation due to scattered emission photons. The excitation foci can also be spaced wider to cover the full FOV of the objective with minimal aberrations. The performance of this system is demonstrated by imaging interneuron morphological structures deep in the brains of living mice.

  4. Perspectives of Cosmesis following Breast Conservation for Multifocal and Multicentric Breast Cancers

    Directory of Open Access Journals (Sweden)

    Mona P. Tan

    2015-01-01

    Full Text Available Background. Contemporary data suggest that breast conservation treatment (BCT for multifocal and multicentric breast cancer (MFMCBC may be appropriate with noninferior local control rates. However, there is a paucity of data to evaluate patient’s satisfaction with cosmetic outcomes after BCT for MFMCBC. This study was performed to bridge this information gap. Methods. All patients treated at the authors’ healthcare facility were included in the study. Patients with MFMCBC who were assessed to be eligible for BCT underwent tumour resection using standard surgical techniques with direct parenchymal closure through a single incision. After at least three years of follow-up, they were invited to participate in a survey regarding their cosmetic outcomes. Results. Of a total of 160 patients, 40 had MFMCBC, of whom 34 (85% underwent successful BCT. Five-year cancer-specific survival and disease-free survival were 95.7%. Twenty of the 34 patients responded to the survey. No patient rated her cosmetic outcome as “poor.” Analysis indicated low agreement between patients’ self-assessment and clinician-directed evaluation of aesthetic results. Conclusion. BCT for MFMCBC is feasible with acceptable survival and cosmetic outcomes. However, there appears to be a disparity between patient and clinician-directed evaluation of cosmetic results which warrant further research.

  5. Successful treatment of chronic recurrent multifocal osteomyelitis using low-dose radiotherapy. A case report

    International Nuclear Information System (INIS)

    Dietzel, Christian T.; Vordermark, Dirk; Schaefer, Christoph

    2017-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, which lacks an infectious genesis and predominantly involves the metaphysis of long bones. Common treatments range from nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids at first onset of disease, to immunosuppressive drugs and bisphosphonates in cases of insufficient remission. The therapeutic use of low-dose radiotherapy for CRMO constitutes a novelty. A 67-year-old female patient presented with radiologically proven CRMO affecting the right tibia/talus and no response to immunosuppressive therapy. Two treatment series of radiation therapy were applied with an interval of 6 weeks. Each series contained six fractions (three fractions per week) with single doses of 0.5 Gy, thus the total applied dose was 6 Gy. Ten months later, pain and symptoms of osteomyelitis had completely vanished. Radiotherapy seems to be an efficient and feasible complementary treatment option for conventional treatment refractory CRMO in adulthood. The application of low doses per fraction is justified by the inflammatory pathomechanism of disease. (orig.) [de

  6. Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies.

    Science.gov (United States)

    Mentzer, Dirk; Prestel, Jürgen; Adams, Ortwin; Gold, Ralf; Hartung, Hans-Peter; Hengel, Hartmut; Kieseier, Bernd C; Ludwig, Wolf-Dieter; Keller-Stanislawski, Brigitte

    2012-09-01

    Novel immunosuppressive/modulating therapies with monoclonal antibodies (MABs) have been associated with progressive multifocal leukoencephalopathy (PML), a potentially fatal disease of the brain caused by the JC virus. Taking the complex diagnostic testing and heterogeneous clinical presentation of PML into account, an agreed case definition for PML is a prerequisite for a thorough assessment of PML. A working group was established to develop a standardised case definition for PML which permits data comparability across clinical trials, postauthorisation safety studies and passive postmarketing surveillance. The case definition is designed to define levels of diagnostic certainty of reported PML cases following treatment with MABs. It was subsequently used to categorise retrospectively suspected PML cases from Germany reported to the Paul-Ehrlich-Institute as the responsible national competent authority. The algorithm of the case definition is based on clinical symptoms, PCR for JC virus DNA in cerebrospinal fluid, brain MRI, and brain biopsy/autopsy. The case definition was applied to 119 suspected cases of PML following treatment with MABs and is considered to be helpful for case ascertainment of suspected PML cases for various MABs covering a broad spectrum of indications. Even if the available information is not yet complete, the case definition provides a level of diagnostic certainty. The proposed case definition permits data comparability among different medicinal products and among active as well as passive surveillance settings. It may form a basis for meaningful risk analysis and communication for regulators and healthcare professionals.

  7. Multifocal electroretinogram and central visual field testing in central areolar choroidal dystrophy.

    Science.gov (United States)

    Gundogan, Fatih Cakir; Dinç, Umut Asli; Erdem, Uzeyir; Ozge, Gokhan; Sobaci, Gungor

    2010-01-01

    To study multifocal electroretinogram (mfERG) and its relation to retinal sensitivity assessed by Humphrey visual field (HVF) analysis in central areolar choroidal dystrophy (CACD). Seven eyes of 4 patients with CACD and 15 normal control subjects were examined. mfERG and central 30/2 HVF were tested for each participant. Ring analysis in mfERG was evaluated. HVF results were evaluated in 5 concentric rings in order to compare the results to concentric ring analysis in mfERG. The differences between control subjects and patients were evaluated by Mann-Whitney U test and the correlations were assessed by Spearman test. Mean Snellen acuity was 0.49+/-0.10 in patients. HVF revealed central scotoma in 6 of 7 eyes (85.7%), whereas a paracentral scotoma extending to fixation point was detected in 1 eye. The retinal sensitivities in 5 concentric rings in HVF were significantly lower (p<0.001 for ring 1 to ring 4, and p=0.017 in ring 5) in CACD patients. Similarly, CACD patients had lower P1/N1 amplitudes (p<0.05) and delayed P1/N1 implicit times (p<0.05). In CACD, in the areas of scotoma detected by HVF, mfERG values were depressed. However, both mfERG and HVF abnormalities were found outside the areas of ophthalmoscopically normal retinal areas.

  8. Frontal and occipital horn ratio is associated with multifocal intraparenchymal hemorrhages in neonatal shunted hydrocephalus.

    Science.gov (United States)

    Oushy, Soliman; Parker, Jonathon J; Campbell, Kristen; Palmer, Claire; Wilkinson, Corbett; Stence, Nicholas V; Handler, Michael H; Mirsky, David M

    2017-11-01

    OBJECTIVE Placement of a cerebrospinal fluid diversion device (i.e., shunt) is a routine pediatric neurosurgical procedure, often performed in the first weeks of life for treatment of congenital hydrocephalus. In the postoperative period, shunt placement may be complicated by subdural, catheter tract, parenchymal, and intraventricular hemorrhages. The authors observed a subset of infants and neonates who developed multifocal intraparenchymal hemorrhages (MIPH) following shunt placement and sought to determine any predisposing perioperative variables. METHODS A retrospective review of the electronic medical record at a tertiary-care children's hospital was performed for the period 1998-2015. Inclusion criteria consisted of shunt placement, age hydrocephalus. Markers of severity of ventriculomegaly (FOR) and ventricular response to CSF diversion (∆FOR) were significantly associated with occurrence of MIPH. Choice of shunt and etiology of hydrocephalus were also significantly associated with MIPH. After adjusting for corrected age, etiology of hydrocephalus, and shunt setting, the authors found that ∆FOR after shunting was still associated with MIPH. A prospective study of MIPH prevention strategies and assessment of possible implications for patient outcomes is needed.

  9. Optical performance of multifocal soft contact lenses via a single-pass method.

    Science.gov (United States)

    Bakaraju, Ravi C; Ehrmann, Klaus; Falk, Darrin; Ho, Arthur; Papas, Eric

    2012-08-01

    A physical model eye capable of carrying soft contact lenses (CLs) was used as a platform to evaluate optical performance of several commercial multifocals (MFCLs) with high- and low-add powers and a single-vision control. Optical performance was evaluated at three pupil sizes, six target vergences, and five CL-correcting positions using a spatially filtered monochromatic (632.8 nm) light source. The various target vergences were achieved by using negative trial lenses. A photosensor in the retinal plane recorded the image point-spread that enabled the computation of visual Strehl ratios. The centration of CLs was monitored by an additional integrated en face camera. Hydration of the correcting lens was maintained using a humidity chamber and repeated instillations of rewetting saline drops. All the MFCLs reduced performance for distance but considerably improved performance along the range of distance to near target vergences, relative to the single-vision CL. Performance was dependent on add power, design, pupil, and centration of the correcting CLs. Proclear (D) design produced good performance for intermediate vision, whereas Proclear (N) design performed well at near vision (p 4 mm in diameter. Acuvue Oasys bifocal produced performance comparable with single-vision CL for most vergences. Direct measurement of single-pass images at the retinal plane of a physical model eye used in conjunction with various MFCLs is demonstrated. This method may have utility in evaluating the relative effectiveness of commercial and prototype designs.

  10. Phase II trial of upfront bevacizumab and temozolomide for unresectable or multifocal glioblastoma

    International Nuclear Information System (INIS)

    Lou, Emil; Peters, Katherine B; Sumrall, Ashley L; Desjardins, Annick; Reardon, David A; Lipp, Eric S; Herndon, James E II; Coan, April; Bailey, Leighann; Turner, Scott; Friedman, Henry S; Vredenburgh, James J

    2013-01-01

    Patients with unresectable glioblastomas have a poor prognosis, with median survival of 6–10 months. We conducted a phase II trial of upfront 5-day temozolomide (TMZ) and bevacizumab (BV) in patients with newly diagnosed unresectable or multifocal glioblastoma. Patients received up to four cycles of TMZ at 200 mg/m 2 on days 1–5, and BV at 10 mg/kg on days 1 and 15 of a 28-day cycle. Brain magnetic resonance imaging (MRI) was performed monthly. Therapy was continued as long as there was no tumor progression, grade 4 nonhematologic toxicity, or recurrent grade 4 hematologic toxicity after dose reduction. The primary end point was best tumor response as measured on MRI. Forty-one patients were accrued over 12 months; 39 had a full set of MRI scans available for evaluation. Assessment for best radiographic responses was as follows: partial responses in 24.4%, stable disease in 68.3%, and progressive disease in 2.4%. Treatment-related toxicities included seven grade 4 toxicities and one grade 5 toxicity (myocardial infarction). From this study, it was concluded that an upfront regimen of TMZ and BV for unresectable glioblastoma was well tolerated and provided a significant level of disease stabilization. Therapeutic toxicities were consistent with those seen in the adjuvant setting using these agents. The upfront approach to treatment of glioblastoma in the unresectable population warrants further investigation in randomized controlled phase III trials

  11. Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people.

    Science.gov (United States)

    Ellison, Ashton C; Campbell, A John; Robertson, M Clare; Sanderson, Gordon F

    2014-01-01

    Multifocal glasses (bifocals, trifocals, and progressives) increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1) map the prismatic displacement of a progressive lens, and 2) test whether this displacement impaired reaction time and accuracy. The reaction times of healthy ≥75-year-olds (31 participants) were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance) glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter. Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis]) and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007). There was no difference in accuracy between the two types of glasses. Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial.

  12. Multifocal small bowel stromal tumours presenting with peritonitis in an HIV positive patient.

    Science.gov (United States)

    Mansoor, Ebrahim

    2014-01-01

    The most common mesenchymal tumour of the gastrointestinal tract is stromal tumours (GISTs). Symptomatic GISTs can present with complications such as haemorrhage, obstruction and perforation. Complete surgical resection with negative margins is the mainstay of treatment but may be imprudent on emergent occasion. Tyrosine-kinase inhibitors (TKIs) have been revolutionary in the treatment of GISTs and have resulted in improved outcomes. A 41 year old HIV positive male presented with an acute history of abdominal pain and obstructive symptoms. Clinical examination revealed sepsis and peritonitis. One of the several small bowel tumours discovered at exploratory laparotomy was necrotic and perforated. The perforated tumour alone was resected and a small bowel internal hernia reduced. The patient made an uneventful recovery and will be considered for TKI therapy with a view to later re-operation. GISTs very rarely perforate. The pathophysiology of stromal tumour necrosis is poorly understood. Multifocality and small bowel location are poor prognosticators and may occur in the setting of familial GISTs, specific syndromes and sporadic cases. There is no established association between HIV and GISTs. Perforation occurs infrequently in ≤8% of symptomatic cases and poses increased risk of local recurrence. The surgical management of perforation takes precedence in an emergency. The surgeon must however take cognisance of the adherence to ideal oncologic principles where feasible. TKI therapy is invaluable if a re-exploration is to be later considered. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  13. Multifocal electroretinogram in normal emmetropic subjects: Correlation with optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Rajvardhan Azad

    2012-01-01

    Full Text Available Aim of the Study: To establish the normative database for multifocal electroretinogram (mfERG parameters in a normal emmetropic population. To correlate the data so obtained with the central macular thickness obtained using the optical coherence tomography (OCT scan. Materials and Methods: mfERG data were obtained from 222 eyes of 111 emmetropic subjects. The amplitude (nv/deg 2 and implicit times (ms of the first-order kernel mfERG responses (N1, P1, and N2 waves were obtained and grouped into five rings (Ring 1: Central 2°, Ring 2: 2-5°, Ring 3: 5-10°, Ring 4: 10-15°, Ring 5: >15°. The central macular thickness (CMT was obtained using the macular thickness scan protocol of the OCT. Results: The mfERG data obtained were used to create a normative database. The amplitudes of the mfERG waves were maximum in the fovea and progressively decreased with increasing eccentricity (P = 0.0001. The latencies of the P1 and N2 waves were longest in the central ring and progressively shortened with eccentricity (P = 0.0001. No statistically significant correlations were observed between central ring 1 parameters and the CMT. Conclusion: This study establishes normative database for mfERG parameters in an emmetropic population. No statistically significant correlation was noted between CMT and mfERG parameters.

  14. Complete resolution and remodeling of chronic recurrent multifocal osteomyelitis on MRI and radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Berkowitz, Y.J.; Greenwood, S.J.; Cassar-Pullicino, V.N. [Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Department of Diagnostic Imaging, Oswestry, Shropshire (United Kingdom); Cribb, G. [Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Department of Orthopaedic Oncology, Oswestry, Shropshire (United Kingdom); Davies, K. [Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Department of Medicine, Oswestry, Shropshire (United Kingdom)

    2018-04-15

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition thought to be under-diagnosed, with a true prevalence of more than the 1 in 10,000 estimated. It is a condition that is classically described as polyostotic with a relapsing and remitting course, preferentially affecting the metaphyses of tubular bones in the pediatric population. Lesions have characteristic appearances of cortical hyperostosis and mixed lytic/sclerotic medullary appearances radiographically, with active osteitis and periostitis best seen with fluid-sensitive sequences on magnetic resonance imaging (MRI). There are reports of lesions resolving on follow-up radiographs and MRI scans, but no supporting images. In particular, although the marrow appearances and degree of osteitis have been shown to improve on MRI, complete resolution and remodeling back to normal has never been demonstrated. We present a case of a lesion that has completely healed and remodeled back to normal appearances on both radiographs and MRI, and consider this the standard for the often loosely used terms ''normalization'' and ''resolution''. We discuss the implications of this for our understanding of the natural history of CRMO, and how this adds weight to the condition being significantly under-diagnosed. It provides a ''gold standard'' to be aimed for when assessing treatments for CRMO, and the optimal outcomes that are possible. It also provides further insight into the potential of pediatric bone to recover and remodel when affected by inflammatory conditions. (orig.)

  15. Comparison on the visual quality after different multifocal lens implantation in cataract patients

    Directory of Open Access Journals (Sweden)

    Si-Meng Qu

    2018-02-01

    Full Text Available AIM: To compare the visual quality after different multifocal lens(MIOLimplantation in cataract patients. METHODS:Totally 78 cases(78 eyesof cataract patients who receiving phacoemulsification and implantation of different MIOL were enrolled from February 2016 to June 2017 in our hospital. According to the different type of implanted MIOL, the 78 cases(78 eyeswere divided Group A, B and C, each group was 26 cases(26 eyes. Patients in the Group A were implanted regional refraction MIOL SBL-3; patients in the Group B implanted step progressive diffraction MIOL SN6AD1; patients in the Group C implanted all-optical plane diffraction MIOL Tecnis ZMB00. The visual acuity, contrast sensitivity, defocus testing, contrast visual acuity and satisfaction of visual quality were compared in 3 groups at postoperative 3mo. RESULTS: There was no statistically significant difference in postoperative adverse reactions between the three groups(P>0.05. There was statistical difference in uncorrected intermediate visual acuity, uncorrected near visual acuity, distance-corrected intermediate visual acuity and distance-corrected near visual acuity in 3 groups(PPPPPPPPPCONCLUSION:The region refraction MIOL SBL-3 not only could provide better distant, intermediate and near visual acuity, but also could provide better contrast sensitivity and contrast visual acuity, thereby greatly increase visual quality satisfaction.

  16. High b-value diffusion-weighted imaging in progressive multifocal leukoencephalopathy in HIV patients

    International Nuclear Information System (INIS)

    Godi, Claudia; De Vita, Enrico; Davagnanam, Indran; Tombetti, Enrico; Haddow, Lewis; Jaeger, Hans Rolf

    2017-01-01

    An ill-defined hyperintense edge and hypointense core on diffusion-weighted imaging (DWI) is typical of progressive multifocal leukoencephalopathy (PML). We aimed to investigate whether a b-value of 3,000 s/mm"2 (b3000) can improve visualisation of PML, or provide different structural information compared to 1,000 s/mm"2 (b1000). We retrospectively identified HIV-positive patients with confirmed PML studied under a clinical protocol including both b1000 and b3000 DWI. The rim and core of each PML lesion and normal-appearing white matter (NAWM) were outlined on trace-weighted DWI. Signal intensities, apparent diffusion coefficient (ADC) values and volumes were measured and compared between b1000 and b3000. Nine lesions from seven patients were analysed. The rim and core were better visualised on b3000, with higher signal of the rim and lower signal of the core compared to NAWM. The hyperintense rim had non-restricted average ADCs, but included foci of low ADC on both b3000 and b1000. Despite similar total lesion volumes, b3000 displayed significantly larger core and smaller rim volumes than b1000. b3000 improves visualisation of this important PML hallmark. Moreover, b3000 partly reclassifies tissue from rim into core, and might provide potentially more accurate biomarkers of PML activity and prognosis. (orig.)

  17. High b-value diffusion-weighted imaging in progressive multifocal leukoencephalopathy in HIV patients

    Energy Technology Data Exchange (ETDEWEB)

    Godi, Claudia [San Raffaele Scientific Institute, Neuroradiology Department, Milan (Italy); The National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); De Vita, Enrico; Davagnanam, Indran [The National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); Tombetti, Enrico [Vita-Salute San Raffaele University, Milan (Italy); Haddow, Lewis [University College London, Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, London (United Kingdom); Jaeger, Hans Rolf [The National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); University College Hospital, Centre of Medical Imaging, London (United Kingdom)

    2017-09-15

    An ill-defined hyperintense edge and hypointense core on diffusion-weighted imaging (DWI) is typical of progressive multifocal leukoencephalopathy (PML). We aimed to investigate whether a b-value of 3,000 s/mm{sup 2} (b3000) can improve visualisation of PML, or provide different structural information compared to 1,000 s/mm{sup 2} (b1000). We retrospectively identified HIV-positive patients with confirmed PML studied under a clinical protocol including both b1000 and b3000 DWI. The rim and core of each PML lesion and normal-appearing white matter (NAWM) were outlined on trace-weighted DWI. Signal intensities, apparent diffusion coefficient (ADC) values and volumes were measured and compared between b1000 and b3000. Nine lesions from seven patients were analysed. The rim and core were better visualised on b3000, with higher signal of the rim and lower signal of the core compared to NAWM. The hyperintense rim had non-restricted average ADCs, but included foci of low ADC on both b3000 and b1000. Despite similar total lesion volumes, b3000 displayed significantly larger core and smaller rim volumes than b1000. b3000 improves visualisation of this important PML hallmark. Moreover, b3000 partly reclassifies tissue from rim into core, and might provide potentially more accurate biomarkers of PML activity and prognosis. (orig.)

  18. Multifocal fibrosing thyroiditis and its association with papillary thyroid carcinoma using BRAF pyrosequencing.

    Science.gov (United States)

    Frank, Renee; Baloch, Zubair W; Gentile, Caren; Watt, Christopher D; LiVolsi, Virginia A

    2014-09-01

    Multifocal fibrosing thyroiditis (MFT) is characterized by numerous foci of fibrosis in a stellate configuration with fibroelastotic and fibroblastic centers entrapping epithelial structures. MFT has been proposed as a risk factor for papillary thyroid carcinoma (PTC) development. We attempted to identify whether MFT showed such molecular changes and could possibly be related to PTC. We identified seven cases of PTC with MFT in our institutional pathology database and personal consult service of one of the authors (VAL) for the years 1999 to 2012. Areas of PTC, MFT, and normal tissue were selected for BRAF analysis. Macro-dissection, DNA extraction and PCR amplification, and pyrosequencing were performed to detect BRAF mutations in codon 600. All of the MFT lesions and normal thyroid tissue were negative for BRAF mutations. Of the seven PTCs analyzed, five (71 %) were negative for BRAF mutations, while two cases were positive. In our study, none of the MFT lesions harbored BRAF mutations, whereas 29 % (two of seven) PTCs in the same gland were positive. Hence, in this small study, we found no evidence that the MFT lesion is a direct precursor to PTC. It is likely an incidental bystander in the process and a reflection of the background thyroiditis.

  19. Multifocal ERG reveals long distance effects of a local bleach in the retina.

    Science.gov (United States)

    Kretschmann, U; Tornow, R P; Zrenner, E

    1998-06-01

    To examine the distribution of ERG-activity in the central visual field after local bleaching of the fovea, multifocal electroretinograms were recorded in eight normal volunteers before, during and after recurrent light exposure. During bleaching (90% bleached pigment), the response density (scalar product) of the foveal area (0-2 degrees eccentricity) decreased from 10.7 +/- 3.5 to 4.1 +/- 1.9 nV/degree2 (P < 0.001). The average activity in the extrafoveal macular area was unchanged, while the amplitudes were frequently (in 53 of 54 areas) enhanced at 5-30.5 degrees eccentricity. Here the average response density changed from 3.1 +/- 0.9 to 3.5 +/- 1.0 nV/degree2 (P < 0.001). A fast recovery of foveal responses after cessation of bleaching occurred. Besides a strong decrease of response in the directly bleached area, local bleaching led to enhanced activity mainly 3-27 degrees distant from the bleached area.

  20. [Multiple myeloma with significant multifocal osteolysis in a dog without a detectible gammopathy].

    Science.gov (United States)

    Souchon, F; Koch, A; Sohns, A

    2013-01-01

    Description of a variant of multiple myeloma in a dog lacking the gammopathy normally associated with this type of neoplasm. A Border Collie mongrel was presented with symptoms of progressive hind-leg weakness, lethargy and tiredness, which had started to appear 6 weeks previously. Radiographic examination showed small osteolytic areas in the spinal column, but also diffuse small areas of increased opacity as well as evidence of decreased bone density in the pelvis and of both femoral necks. Moderate regenerative anaemia, hypogammopathy and hypercalcaemia were diagnosed. Computed tomography scans displayed multifocal osteolysis and bone destruction in the skull, spinal column, scapulae, proximal humeri, pelvis and femoral necks. H&E staining of the biopsies showed bone destruction and monomorphic plasmacyotid cell populations, causing infiltrative bone marrow lesions and osteolysis. In many areas neoplastic plasma cell infiltration of the bone marrow was 70% and in some areas reached 100%. The diagnosis was non-secretory multiple myeloma without apparent secretion of paraproteins into the blood.

  1. Perfil dos alunos usuários de lentes de contato do curso de Medicina da Universidade Estadual Paulista - UNESP - Botucatu Profile of medical students from the Universidade Estadual Paulista - UNESP - Botucatu, who wear contact lenses

    Directory of Open Access Journals (Sweden)

    Vanessa Gonçalves Vidotti

    2006-04-01

    Full Text Available OBJETIVO: Analisar o perfil dos usuários de lentes de contato entre os estudantes de medicina da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista - UNESP - Botucatu (SP, quanto à ametropia, à aquisição, aos cuidados e às complicações. MÉTODOS: Foi aplicado um questionário aos alunos do 1º ao 6º ano de Medicina da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista - UNESP - Botucatu (SP, perfazendo um estudo analítico transversal. RESULTADOS: Foram 566 entrevistados. Destes, 155 (27,4% usavam lente de contato. Das lentes de contato usadas, 94,8% eram gelatinosas, e em 98,7% o grau era negativo. O descarte dessas lentes era mensal em 46,9% dos entrevistados e 63,9% a utilizavam, em média, 14 horas/dia. Faziam aquisição da lente de contato em óptica ou farmácia 14,1% dos estudantes. Faziam a higiene ao colocá-las e ao retirá-las dos olhos, 46,5%. As complicações referentes aos olhos vermelhos eram 51,0%; 44,5%, embaçamento; e 42,6%, sensação de corpo estranho, além de 4 estudantes relatarem "ceratite". CONCLUSÕES: A maioria dos alunos utilizava lentes hidrofílicas, descarte mensal e grau negativo. A adaptação inadequada, aquisição de lentes de contato em ópticas ou farmácias e complicações graves ocorreram, mesmo nos usuários socioculturalmente considerados diferenciados. Em vista disso, demanda a extrema necessidade de maior atenção na abordagem do tema em questão, a fim de prevenir o comprometimento visual permanente.PURPOSE: To analyze the ametropy, way of acquisition, the care and complications related to contact lens wear among medical students from Faculdade de Medicina de Botucatu da Universidade Estadual Paulista - UNESP - Botucatu (SP. METHODS: Questionnaire applied to students from the 1st to the 6th year of the Medical school of the Faculdade de Medicina de Botucatu da Universidade Estadual Paulista - UNESP - Botucatu (SP, forming an analytical cross

  2. Desempenho visual na correção de miopia com óculos e lentes de contato gelatinosas Visual performance in myopic correction with spectacles and soft contact lenses

    Directory of Open Access Journals (Sweden)

    Breno Barth

    2008-02-01

    Full Text Available OBJETIVOS: Avaliar o desempenho visual, por meio da acuidade visual LogMAR de alto contraste, sensibilidade ao contraste e análise de frentes de onda de indivíduos portadores de miopia com ou sem astigmatismo, corrigidos com óculos e com três diferentes lentes de contato gelatinosas [Acuvue® 2 (Vistacon J&J Vision Care Inc., EUA, Biomedics® 55 (Ocular Science, EUA e Focus® 1-2 week (Ciba Vision Corporation, EUA]. MÉTODOS: Estudo clínico e prospectivo com intervenção em amostra constituída por quarenta indivíduos portadores de miopia entre -1,00 D e -4,50 D, sem ou com astigmatismo até -0,75 D. RESULTADOS: A sobrerefração objetiva realizada pelo aberrômetro Zywave detectou diferença significativa entre as lentes de contato gelatinosas Acuvue® 2 e Biomedics® 55, em relação aos componentes refrativos esfera e equivalente esférico, que se mostraram hipercorrigidos em relação às lentes de contato gelatinosas Focus® 1-2 week. A acuidade visual LogMAR e sensibilidade ao contraste não detectaram diferenças no desempenho visual com os óculos e com as três lentes de contato gelatinosas. A análise de frentes de onda detectou diferença significativa na aberração de terceira ordem sem e com as lentes de contato gelatinosas, com melhor desempenho visual com as lentes de contato gelatinosas Acuvue® 2 e Biomedics® 55. CONCLUSÕES: A análise de frentes de onda detectou diferenças no desempenho visual com óculos e com as lentes de contato gelatinosas, sendo, portanto, uma medida mais sensível da função visual que a acuidade visual LogMAR de alto contraste e a sensibilidade ao contraste. O modelo de avaliação de desempenho visual com análise de frentes de onda utilizado nesta investigação serve de modelo para pesquisas semelhantes.PURPOSE: To evaluate the visual performance by high contrast visual acuity, contrast sensitivity and wavefront in myopic patients with or without astigmatism corrected with spectacles and

  3. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    Energy Technology Data Exchange (ETDEWEB)

    Gotthardt, M. [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Nuclear Medicine; Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Rubner, C. [Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Bauhofer, A. [Philipps Univ., Marburg (DE). Inst. of Theoretical Surgery] (and others)

    2006-07-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76{+-}80.6 Gy versus 125.6{+-}46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2{+-}101.7 Gy versus 125.6{+-}46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  4. Results of a TcTUs-optimized radioiodine therapy of multifocal and disseminated functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Endlicher, D.; Prillwitz, A.; Rudolph, F.; Groth, P.; Schuemichen, C.

    1999-01-01

    Aim: The presented study prospectively evaluates the efficacy of optimized radioiodine therapy in patients (pts) with multifocal (MFA) and disseminated (DISA) autonomy. The target dose was related to the total thyroid volume and was increased in moderate and nonlinear increments for 150 to 300 Gy dependent on the pretherapeutic Tc-99m pertechnetate thyroid uptake under suppression (TcTUs). Patients with focal autonomy were treated with a target dose independent of TcTUs and were used as control group. Methods: The data of 641 pts (518 women, 123 men) were evaluated, 466 pts with MFA or DISA and 175 pts with focal autonomy. In pts with MFA and DISA the target dose was increased in four steps: TcTUs 3-6%: 200 Gy, >6-12%: 250 Gy and >12%: 300 Gy. In pts with focal autonomy a fixed target dose of 300 or 400 Gy was applied. The radioactivity to be administered was calculated using a modified Marinelli formula. The follow-up examination was performed at the earliest after four, on average after eight months. Normalization of TSH was the only criterion for successful therapy. Results: The success rate in pts with latent or manifest hyperthyroidism in focal autonomy was 91.5%, thereby was not successful in 5.1% and hypothyroidism occurred in 3.4%. The average success rate in pts with MFA and DISA was 91.5%, therapy failed in 7.5% and a very low rate of 1% with hypothyroidism was seen. Conclusion: The presented optimized therapy concept with calculated, nonlinear increase of the target dose according to the TcTUs-level guaranteed even in MFA and DISA a high success rate comparable to that in focal autonomy along with a very low rate of hypothyroidism. (orig.) [de

  5. Paucity of bone scan abnormalities in a child with multifocal osteomyelitis and disseminated sepsis

    International Nuclear Information System (INIS)

    Trpezanovski, J.; Porn, U.; Uren, R.; Howman-Giles, R.; Mansberg, R.

    2000-01-01

    Full text: We present an unusual case of multifocal osteomyelitis with minimal bone scan abnormalities and markedly discordant findings on Magnetic Resonance Imaging(MRI) and gallium scans. A seven-year-old female presented with left leg, right elbow pain and fever. A bone scan was performed. Mild increased vascularity was demonstrated on the dynamic and blood pool phases of the study in the area of the right elbow. In the delayed images there was a photopenic lesion in the left distal femoral metadiaphysis and also irregular uptake in the metaphyseal regions of the long bones. Low grade soft tissue tracer uptake was seen in the left thigh and right forearm. The patient deteriorated clinically and underwent further investigations with MRI and gallium scans. The MRI showed extensive abnormalities with mulitlocular fluid collection seen throughout most of the muscle groups of both thighs suggesting myositis with an associated cellulitis and osteomyelitis of the left femur. The gallium study was markedly abnormal with increased uptake in the distal 2/3rds of the left femur, proximal 1/2 of the right femur, right proximal forearm (mid forearm extending to mid upper arm), left proximal humerus and right hemithorax especially the lower zones. Staphylococcal aureus was cultured. The patient required intensive care management and slowly responded to antibiotic therapy and surgery to drain abscesses in the thighs. A bone marrow biopsy was normal and immunological tests were performed but a result has yet to be determined. The lack of increased bone uptake in the demonstrated areas of osteomyelitis maybe explained on the basis of an overwhelming infective process inhibiting the patient's healing response. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  6. Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a man with AIDS

    Directory of Open Access Journals (Sweden)

    Yoganathan K

    2012-04-01

    Full Text Available Katie Yoganathan1, David Brown2, Kathir Yoganathan31Cardiff Medical School, Cardiff, Wales, UK; 2Virus Reference Department, Microbiology Services, Health Protection Agency, London, UK; 3Singleton Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, UKAbstract: A 43-year-old Caucasian homosexual man with AIDS presented with blurring of vision, change of personality, and memory loss in March 1999. He had first been admitted 2 months previously for treatment of Pneumocystis jiroveci pneumonia. A magnetic resonance imaging scan on admission showed multiple white matter lesions involving both subcortical cerebral hemispheres and cerebellar regions, with no mass effect or surrounding edema. JC virus was detected by nested polymerase chain reaction in the cerebrospinal fluid. These findings were diagnostic of progressive multifocal leukoencephalopathy (PML. His CD4 count was 34 cells/mL, and his HIV ribonucleic acid level was 800,789 copies/mL. He was treated with a combination antiretroviral therapy. He was last reviewed in October 2011. He was fully independent socially and mentally, but he still had some residual neurologic signs with right-sided homonymous hemianopia and visual agnosia. His HIV ribonucleic acid level was undetectable, and his CD4 count was 574 cells/mm3. Although the median survival of patients with PML was poor before the antiretroviral therapy era, our patient, who is now aged 55 years, is still alive 12 years after the diagnosis. The diagnosis of PML and differential diagnosis of focal neurologic signs in HIV-positive patients are discussed in this case report.Keywords: HIV, focal neurologic signs, cerebral toxoplasmosis, primary brain lymphoma, ischaemic stroke

  7. Multifocal visual evoked potential in optic neuritis, ischemic optic neuropathy and compressive optic neuropathy

    Science.gov (United States)

    Jayaraman, Manju; Gandhi, Rashmin Anilkumar; Ravi, Priya; Sen, Parveen

    2014-01-01

    Purpose: To investigate the effect of optic neuritis (ON), ischemic optic neuropathy (ION) and compressive optic neuropathy (CON) on multifocal visual evoked potential (mfVEP) amplitudes and latencies, and to compare the parameters among three optic nerve disorders. Materials and Methods: mfVEP was recorded for 71 eyes of controls and 48 eyes of optic nerve disorders with subgroups of optic neuritis (ON, n = 21 eyes), ischemic optic neuropathy (ION, n = 14 eyes), and compressive optic neuropathy (CON, n = 13 eyes). The size of defect in mfVEP amplitude probability plots and relative latency plots were analyzed. The pattern of the defect in amplitude probability plot was classified according to the visual field profile of optic neuritis treatment trail (ONTT). Results: Median of mfVEP amplitude (log SNR) averaged across 60 sectors were reduced in ON (0.17 (0.13-0.33)), ION (0.14 (0.12-0.21)) and CON (0.21 (0.14-0.30)) when compared to controls. The median mfVEP relative latencies compared to controls were significantly prolonged in ON and CON group of 10.53 (2.62-15.50) ms and 5.73 (2.67-14.14) ms respectively compared to ION group (2.06 (-4.09-13.02)). The common mfVEP amplitude defects observed in probability plots were diffuse pattern in ON, inferior altitudinal defect in ION and temporal hemianopia in CON eyes. Conclusions: Optic nerve disorders cause reduction in mfVEP amplitudes. The extent of delayed latency noted in ischemic optic neuropathy was significantly lesser compared to subjects with optic neuritis and compressive optic neuropathy. mfVEP amplitudes can be used to objectively assess the topography of the visual field defect. PMID:24088641

  8. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Haakma, Wieke [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Aarhus University, Department of Forensic Medicine and Comparative Medicine Lab, Aarhus (Denmark); Jongbloed, Bas A.; Goedee, H.S.; Berg, Leonard H. van den; Pol, W.L. van der [University Medical Center Utrecht, Brain Centre Rudolf Magnus, Department of Neurology and Neurosurgery, Utrecht (Netherlands); Froeling, Martijn; Bos, Clemens; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Leemans, Alexander [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2017-05-15

    To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls (HCs). Patients underwent MRI (in a prone position) and nerve conduction studies. DTI and fat-suppressed T2-weighted scans of the forearms were performed on a 3.0T MRI scanner. Fibre tractography of the median and ulnar nerves was performed to extract diffusion parameters: fractional anisotropy (FA), mean (MD), axial (AD) and radial (RD) diffusivity. Cross-sectional areas (CSA) were measured on T2-weighted scans. Forty-five out of 60 arms were included in the analysis. AD was significantly lower in MMN patients (2.20 ± 0.12 x 10{sup -3} mm{sup 2}/s) compared to ALS patients (2.31 ± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05) and HCs (2.31± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05). Segmental analysis showed significant restriction of AD, RD and MD (p < 0.005) in the proximal third of the nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p < 0.01). Thickening of nerves is compatible with changes in the myelin sheath structure, whereas lowered AD values suggest axonal dysfunction. These findings suggest that myelin and axons are diffusely involved in MMN pathogenesis. (orig.)

  9. Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people

    Directory of Open Access Journals (Sweden)

    Ellison AC

    2014-05-01

    Full Text Available Ashton C Ellison, A John Campbell, M Clare Robertson, Gordon F SandersonDunedin School of Medicine, Department of Medicine, Dunedin, New ZealandBackground: Multifocal glasses (bifocals, trifocals, and progressives increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1 map the prismatic displacement of a progressive lens, and 2 test whether this displacement impaired reaction time and accuracy.Methods: The reaction times of healthy ≥75-year-olds (31 participants were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter.Results: Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis] and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007. There was no difference in accuracy between the two types of glasses.Conclusion: Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial.Keywords: fall prevention, false projection, stored visual spatial information

  10. Magnetic Resonance Imaging-Guided Osseous Biopsy in Children With Chronic Recurrent Multifocal Osteomyelitis

    International Nuclear Information System (INIS)

    Fritz, Jan; Tzaribachev, Nikolay; Thomas, Christoph; Wehrmann, Manfred; Horger, Marius S.; Carrino, John A.; König, Claudius W.; Pereira, Philippe L.

    2012-01-01

    Purpose: To report the safety and diagnostic performance of magnetic resonance (MRI)—guided core biopsy of osseous lesions in children with chronic recurrent multifocal osteomyelitis (CRMO) that were visible on MRI but were occult on radiography and computed tomography (CT). Materials and Methods: A retrospective analysis of MRI-guided osseous biopsy performed in seven children (four girls and three boys; mean age 13 years (range 11 to 14) with CRMO was performed. Indication for using MRI guidance was visibility of lesions by MRI only. MRI-guided procedures were performed with 0.2-Tesla (Magnetom Concerto; Siemens, Erlangen, Germany; n = 5) or 1.5-T (Magnetom Espree; Siemens; n = 2) open MRI systems. Core needle biopsy was obtained using an MRI-compatible 4-mm drill system. Conscious sedation or general anesthesia was used. Parameters evaluated were lesion visibility, technical success, procedure time, complications and microbiology, cytology, and histopathology findings. Results: Seven of seven (100%) targeted lesions were successfully visualized and sampled. All obtained specimens were sufficient for histopathological analysis. Length of time of the procedures was 77 min (range 64 to 107). No complications occurred. Histopathology showed no evidence of malignancy, which was confirmed at mean follow-up of 50 months (range 28 to 78). Chronic nonspecific inflammation characteristic for CRMO was present in four of seven (58%) patients, and edema with no inflammatory cells was found in three of seven (42%) patients. There was no evidence of infection in any patient. Conclusion: MRI-guided osseous biopsy is a safe and accurate technique for the diagnosis of pediatric CRMO lesions that are visible on MRI only.

  11. Facilitating the analysis of the multifocal electroretinogram using the free software environment R.

    Science.gov (United States)

    Bergholz, Richard; Rossel, Mirjam; Dutescu, Ralf M; Vöge, Klaas P; Salchow, Daniel J

    2018-01-01

    The large amount of data rendered by the multifocal electroretinogram (mfERG) can be analyzed and visualized in various ways. The evaluation and comparison of more than one examination is time-consuming and prone to create errors. Using the free software environment R we developed a solution to average the data of multiple examinations and to allow a comparison of different patient groups. Data of single mfERG recordings as exported in .csv format from a RETIport 21 system (version 7/03, Roland Consult) or manually compiled .csv files are the basis for the calculations. The R software extracts response densities and implicit times of N1 and P1 for the sum response, each ring eccentricity, and each single hexagon. Averages can be calculated for as many subjects as needed. The mentioned parameters can then be compared to another group of patients or healthy subjects. Application of the software is illustrated by comparing 11 patients with chloroquine maculopathy to a control group of 7 healthy subjects. The software scripts display response density and implicit time 3D plots of each examination as well as of the group averages. Differences of the group averages are presented as 3D and grayscale 2D plots. Both groups are compared using the t-test with Bonferroni correction. The group comparison is furthermore illustrated by the average waveforms and by boxplots of each eccentricity. This software solution on the basis of the programming language R facilitates the clinical and scientific use of the mfERG and aids in interpretation and analysis.

  12. Chronic recurrent multifocal osteomyelitis: a radiological and clinical investigation of five cases

    International Nuclear Information System (INIS)

    Demharter, J.; Bohndorf, K.; Michl, W.; Vogt, H.

    1997-01-01

    Objective. To make a detailed evaluation of the clinical and radiological course of five children with chronic recurrent multifocal osteomyelitis (CRMO). Emphasis was laid on the correlation between clinical data and radiological findings. Design and patients. Clinical data, histology (n=11), bone scintigraphy (n=17), and the plain radiographs (n=198) of these patients were reviewed. The mean time of observation was 6.6 years (range 1-14.5 years). Thirty-two lesions seen at the time of primary diagnosis (n=22) or during the course of the disease (n=10) were evaluated. Twenty-seven foci were located in bone; in five cases the sacroiliac joints were involved. Results. Bone scintigrams showed nearly all foci (31/32) and were especially helpful in clinically asymptomatic lesions (14/32) or foci which were radiographically difficult to detect or not seen at all (8/32). Only 14 of 32 foci were locally symptomatic clinically. In all cases with a short interval (≤3 weeks) between the onset of local symptoms and evaluation by plain radiographs (n=5) osteolysis was shown without a sclerotic margin. All bone lesions with a longer duration of local symptoms (n=7) revealed a variable radiographic pattern: osteolysis with sclerotic rim in three, a mixed lytic-sclerotic lesion in three and pure sclerosis in one. In two cases low back pain could be ascribed to sacroiliitis. Conclusion. Only careful correlation between clinical, scintigraphy and radiographic features permits an accurate assessment of disease activity in CRMO. The bone lesions detected radiographically soon after the onset of symptoms resemble those of acute osteomyelitis. (orig.)

  13. What monitor can replace the cathode-ray tube for visual stimulation to elicit multifocal electroretinograms?

    Science.gov (United States)

    Matsumoto, Celso Soiti; Shinoda, Kei; Matsumoto, Harue; Seki, Keisuke; Nagasaka, Eiichiro; Iwata, Takeshi; Mizota, Atsushi

    2014-08-05

    To compare a conventional cathode-ray tube (CRT) screen to organic light-emitting diode (OLED) and liquid crystal display (LCD) screens as visual stimulators to elicit multifocal electroretinograms (mfERGs), mfERGs were recorded from seven eyes of seven healthy volunteers (21 ± 2 years). The mfERGs elicited by a conventional CRT screen (S710, Compaq Computer Co.) were compared to those elicited by a studio-grade master OLED monitor (PVM-1741, Sony, Japan) and a conventional LCD (S1721, Flexscan, Eizo Nanao Corp., Japan). The luminance changes of each monitor were measured with a photodiode. CRT, OLED, and LCD screens with a frame frequency of 60 Hz were studied. A hexagonal stimulus array with 61 stimulus elements was created on each monitor. The serial white stimuli of the OLED screen at 60 Hz did not fuse, and that of the LCD screens fused. The amplitudes of P1 and P2 of the first-order kernels of the mfERGs were not significantly different from those elicited by the CRT and OLED screens, and the P1 amplitude of the first-order kernel elicited by the LCD stimuli was significantly smaller than that elicited by the CRT in all the groups of the averaged hexagonal elements. The implicit times were approximately 10 ms longer in almost all components elicited by the LCD screen compared to those elicited by the CRT screen. The mfERGs elicited by monitors other than the CRT should be carefully interpreted, especially those elicited by LCD screens. The OLED had good performance, and we conclude that it can replace the CRT as a stimulator for mfERGs; however, a collection of normative data is recommended. © 2014 ARVO.

  14. Losing focus: how lens position and viewing angle affect the function of multifocal lenses in fishes.

    Science.gov (United States)

    Gagnon, Yakir Luc; Wilby, David; Temple, Shelby Eric

    2016-09-01

    Light rays of different wavelengths are focused at different distances when they pass through a lens (longitudinal chromatic aberration [LCA]). For animals with color vision this can pose a serious problem, because in order to perceive a sharp image the rays must be focused at the shallow plane of the photoreceptor's outer segments in the retina. A variety of fish and tetrapods have been found to possess multifocal lenses, which correct for LCA by assigning concentric zones to correctly focus specific wavelengths. Each zone receives light from a specific beam entrance position (BEP) (the lateral distance between incoming light and the center of the lens). Any occlusion of incoming light at specific BEPs changes the composition of the wavelengths that are correctly focused on the retina. Here, we calculated the effect of lens position relative to the plane of the iris and light entering the eye at oblique angles on how much of the lens was involved in focusing the image on the retina (measured as the availability of BEPs). We used rotational photography of fish eyes and mathematical modeling to quantify the degree of lens occlusion. We found that, at most lens positions and viewing angles, there was a decrease of BEP availability and in some cases complete absence of some BEPs. Given the implications of these effects on image quality, we postulate that three morphological features (aphakic spaces, curvature of the iris, and intraretinal variability in spectral sensitivity) may, in part, be adaptations to mitigate the loss of spectral image quality in the periphery of the eyes of fishes.

  15. Spectral Tuning in the Eyes of Deep-Sea Lanternfishes (Myctophidae): A Novel Sexually Dimorphic Intra-Ocular Filter

    KAUST Repository

    De Busserolles, Fanny; Hart, Nathan S.; Hunt, David M.; Davies, Wayne I.; Marshall, N. Justin; Clarke, Michael W.; Hahne, Dorothee; Collin, Shaun P.

    2015-01-01

    Deep-sea fishes possess several adaptations to facilitate vision where light detection is pushed to its limit. Lanternfishes (Myctophidae), one of the world's most abundant groups of mesopelagic fishes, possess a novel and unique visual specialisation, a sexually dimorphic photostable yellow pigmentation, constituting the first record of a visual sexual dimorphism in any non-primate vertebrate. The topographic distribution of the yellow pigmentation across the retina is species specific, varying in location, shape and size. Spectrophotometric analyses reveal that this new retinal specialisation differs between species in terms of composition and acts as a filter, absorbing maximally between 356 and 443 nm. Microspectrophotometry and molecular analyses indicate that the species containing this pigmentation also possess at least 2 spectrally distinct rod visual pigments as a result of a duplication of the Rh1 opsin gene. After modelling the effect of the yellow pigmentation on photoreceptor spectral sensitivity, we suggest that this unique specialisation acts as a filter to enhance contrast, thereby improving the detection of bioluminescent emissions and possibly fluorescence in the extreme environment of the deep sea. The fact that this yellow pigmentation is species specific, sexually dimorphic and isolated within specific parts of the retina indicates an evolutionary pressure to visualise prey/predators/mates in a particular part of each species' visual field. © 2015 S. Karger AG, Basel.

  16. Spectral Tuning in the Eyes of Deep-Sea Lanternfishes (Myctophidae): A Novel Sexually Dimorphic Intra-Ocular Filter

    KAUST Repository

    De Busserolles, Fanny

    2015-03-06

    Deep-sea fishes possess several adaptations to facilitate vision where light detection is pushed to its limit. Lanternfishes (Myctophidae), one of the world\\'s most abundant groups of mesopelagic fishes, possess a novel and unique visual specialisation, a sexually dimorphic photostable yellow pigmentation, constituting the first record of a visual sexual dimorphism in any non-primate vertebrate. The topographic distribution of the yellow pigmentation across the retina is species specific, varying in location, shape and size. Spectrophotometric analyses reveal that this new retinal specialisation differs between species in terms of composition and acts as a filter, absorbing maximally between 356 and 443 nm. Microspectrophotometry and molecular analyses indicate that the species containing this pigmentation also possess at least 2 spectrally distinct rod visual pigments as a result of a duplication of the Rh1 opsin gene. After modelling the effect of the yellow pigmentation on photoreceptor spectral sensitivity, we suggest that this unique specialisation acts as a filter to enhance contrast, thereby improving the detection of bioluminescent emissions and possibly fluorescence in the extreme environment of the deep sea. The fact that this yellow pigmentation is species specific, sexually dimorphic and isolated within specific parts of the retina indicates an evolutionary pressure to visualise prey/predators/mates in a particular part of each species\\' visual field. © 2015 S. Karger AG, Basel.

  17. Clinical Evaluation of Reading Performance Using the Salzburg Reading Desk With a Refractive Rotational Asymmetric Multifocal Intraocular Lens.

    Science.gov (United States)

    Linz, Katharina; Attia, Mary S A; Khoramnia, Ramin; Tandogan, Tamer; Kretz, Florian T; Auffarth, Gerd Uwe

    2016-08-01

    To evaluate functional results and reading performance using the Salzburg Reading Desk after implantation of a sector-shaped near-embedded, rotational asymmetrical multifocal intraocular lens (IOL) and a multifocal toric IOL with a +3.00 diopter (D) near addition. In a prospective study, the LentisMplus and Mplus toric IOLs (Oculentis GmbH, Berlin, Germany) were implanted in 34 eyes of 18 patients at the University Eye Hospital of Heidelberg. Uncorrected and corrected distance visual acuity (UDVA, CDVA) and uncorrected and corrected near visual acuity (UNVA, CNVA) were evaluated using standardized visual acuity charts (ETDRS). The Salzburg Reading Desk was used to analyze unilateral and bilateral uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at a set (40 cm/80 cm) and subjective chosen near and intermediate distance. Postoperatively, the median UDVA was 0.08 logMAR (20/25 Snellen) and the median CDVA was 0.01 logMAR (20/20 Snellen). The median UNVA was 0.12 logMAR (20/25 Snellen) and the median CNVA was 0.03 logMAR (20/20 Snellen). The median uncorrected reading acuity measured with the Salzburg Reading Desk for near distance at 40 cm was 0.18 logMAR (20/32 Snellen). The subjectively preferred near distance was 39 cm and revealed similar visual acuity results. The best reading acuity for intermediate distance with a median of 0.22 logMAR (20/32 Snellen) was achieved at a median distance of 62 cm. Reading performance of the multifocal IOL corresponded for near standardized and individual distance, whereas reading function was better at the patient's preferred intermediate distance. [J Refract Surg. 2016;32(8):526-532.]. Copyright 2016, SLACK Incorporated.

  18. Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: Metaanalysis of peer-reviewed publications.

    Science.gov (United States)

    Rosen, Emanuel; Alió, Jorge L; Dick, H Burkhard; Dell, Steven; Slade, Stephen

    2016-02-01

    We performed a metaanaysis of peer-reviewed studies involving implantation of a multifocal intraocular lens (IOL) in presbyopic patients with cataract or having refractive lens exchange (RLE). Previous reviews have considered the use of multifocal IOLs after cataract surgery but not after RLE, whereas greater insight might be gained from examining the full range of studies. Selected studies were examined to collate outcomes with monocular and binocular uncorrected distance, intermediate, and near visual acuity; spectacle independence; contrast sensitivity; visual symptoms; adverse events; and patient satisfaction. In 8797 eyes, the mean postoperative monocular uncorrected distance visual acuity (UDVA) was 0.05 logMAR ± 0.006 (SD) (Snellen equivalent 20/20(-3)). In 6334 patients, the mean binocular UDVA was 0.04 ± 0.00 logMAR (Snellen equivalent 20/20(-2)), with a mean spectacle independence of 80.1%. Monocular mean UDVA did not differ significantly between those who had a cataract procedure and those who had an RLE procedure. Neural adaptation to multifocality may vary among patients. Dr. Alió is a clinical research investigator for Hanita Lenses, Carl Zeiss Meditec AG, Topcon Medical Systems, Inc., Oculentis GmbH, and Akkolens International BV. Dr. Dell is a consultant to Bausch & Lomb and Abbott Medical Optics, Inc. Dr. Slade is a consultant to Alcon Surgical, Inc., Carl Zeiss Meditec AG, and Bausch & Lomb. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  19. Correlation of visual performance with quality of life and intraocular aberrometric profile in patients implanted with rotationally asymmetric multifocal IOLs.

    Science.gov (United States)

    Ramón, María L; Piñero, David P; Pérez-Cambrodí, Rafael J

    2012-02-01

    To examine the visual performance of a rotationally asymmetric multifocal intraocular lens (IOL) by correlating the defocus curve of the IOL-implanted eye with the intraocular aberrometric profile and impact on the quality of life. A prospective, consecutive, case series study including 26 eyes from 13 patients aged between 50 and 83 years (mean: 65.54±7.59 years) was conducted. All patients underwent bilateral cataract surgery with implantation of a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 MF30, Oculentis GmbH). Distance and near visual acuity outcomes, intraocular aberrations, defocus curve, and quality of life (assessed using the National Eye Institute Visual Functioning Questionnaire-25) were evaluated postoperatively (mean follow-up: 6.42±2.24 months). A significant improvement in distance visual acuity was found postoperatively (P<.01). Mean postoperative logMAR distance-corrected near visual acuity was 0.19±0.12 (∼20/30). Corrected distance visual acuity and near visual acuity of 20/20 or better were achieved by 30.8% and 7.7% of eyes, respectively. Of all eyes, 96.2% had a postoperative addition between 0 and 1.00 diopter (D). The defocus curve showed two peaks of maximum visual acuity (0 and 3.00 D of defocus), with an acceptable range of intermediate vision. LogMAR visual acuity corresponding to near defocus was directly correlated with some higher order intraocular aberrations (r⩾0.44, P⩽.04). Some difficulties evaluated with the quality of life test correlated directly with near and intermediate visual acuity (r⩾0.50, P⩽.01). The Lentis Mplus multifocal IOL provides good distance, intermediate, and near visual outcomes; however, the induced intraocular aberrometric profile may limit the potential visual benefit. Copyright 2012, SLACK Incorporated.

  20. [Sentinel node biopsy in patients with multifocal and multicentric breast cancer: A 5-year follow-up].

    Science.gov (United States)

    Blanco Saiz, I; López Carballo, M T; Martínez Fernández, J; Carrión Maldonado, J; Cabrera Pereira, A; Moral Alvarez, S; Santamaría Girón, L; Cantero Cerquella, F; López Secades, A; Díaz González, D; Llaneza Folgueras, A; Aira Delgado, F J

    2014-01-01

    Sentinel lymph node biopsy (SLNB) as a staging procedure in multiple breast cancer is a controversial issue. We have aimed to evaluate the efficacy of sentinel node (SN) detection in patients with multifocal or multicentric breast cancer as well as the safety of its clinical application after a long follow-up. A prospective descriptive study was performed. Eighty-nine patients diagnosed of multiple breast cancer (73 multifocal; 16 multicentric) underwent SLNB. These patients were compared to those with unifocal neoplasia. Periareolar radiocolloid administration was performed in most of the patients. Evaluation was made at an average of 67.2 months of follow-up (32-126 months). Scintigraphic and surgical SN localization in patients with multiple breast cancer were 95.5% and 92.1%, respectively. A higher percentage of extra-axillary nodes was observed than in the unifocal group (11.7% vs 5.4%) as well as a significantly higher number of SN per patient (1.70 vs 1.38). The rate of SN localization in multicentric cancer was slightly lower than in multifocal cancer (87.5% vs 93.1%), and the finding of extra-axillary drainages was higher (20% vs 10%). Number of SN per patient was significantly higher in multicentric breast cancer (2.33 vs 1.57). No axillary relapses have been demonstrated in the follow-up in multiple breast cancer patients group. SLNB performed by periareolar injection is a reliable and accurate staging procedure of patients with multiple breast cancer, including those with multicentric processes. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  1. Biphasic papillary renal cell carcinoma is a rare morphological variant with frequent multifocality: a study of 28 cases.

    Science.gov (United States)

    Trpkov, Kiril; Athanazio, Daniel; Magi-Galluzzi, Cristina; Yilmaz, Helene; Clouston, David; Agaimy, Abbas; Williamson, Sean R; Brimo, Fadi; Lopez, Jose I; Ulamec, Monika; Rioux-Leclercq, Nathalie; Kassem, Maysoun; Gupta, Nilesh; Hartmann, Arndt; Leroy, Xavier; Bashir, Samir Al; Yilmaz, Asli; Hes, Ondřej

    2018-04-01

    To further characterise biphasic squamoid renal cell carcinoma (RCC), a recently proposed variant of papillary RCC. We identified 28 tumours from multiple institutions. They typically showed two cell populations-larger cells with eosinophilic cytoplasm and higher-grade nuclei, surrounded by smaller, amphophilic cells with scanty cytoplasm. The dual morphology was variable (median 72.5% of tumour, range 5-100%); emperipolesis was found in all cases. The male/female ratio was 2:1, and the median age was 55 years (range 39-86 years). The median tumour size was 20 mm (range 9-65 mm). Pathological stage pT1a was found in 21 cases, pT1b in three, and pT3a and pT3b in one each (two not available). Multifocality was found in 32%: multifocal biphasic RCC in one case, biphasic + papillary RCC in two cases, biphasic + clear cell RCC in three cases, biphasic + low-grade urothelial carcinoma of the renal pelvis in one case, and biphasic + Birt-Hogg-Dubé syndrome in one case. Positive immunostains included: PAX8, cytokeratin (CK) 7, α-methylacyl-CoA racemase, epithelial membrane antigen, and vimentin. Cyclin D1 was expressed only in the larger cells. The Ki67 index was higher in the larger cells (median 5% versus ≤1%). Negative stains included: carbonic anhydrase 9, CD117, GATA-3, WT1, CK5/6, and CK20; CD10 and 34βE12 were variably expressed. Gains of chromosomes 7 and 17 were found in two evaluated cases. Follow-up was available for 23 patients (median 24 months, range 1-244 months): 19 were alive without disease, one was alive with recurrence, and one had died of disease (two had died of other causes). Biphasic papillary RCC is a rare variant of papillary RCC, and is often multifocal. © 2017 John Wiley & Sons Ltd.

  2. Food and Drug Administration study update. One-year results from 671 patients with the 3M multifocal intraocular lens.

    Science.gov (United States)

    Lindstrom, R L

    1993-01-01

    The clinical evaluation of the Food and Drug Administration study of the 3M diffractive multifocal intraocular lens (IOL) is presented here to demonstrate the results of 1-year postoperative data accumulated for 671 patients, the first of whom received the implant in 1987. Patients were selected for study if they had absence of preoperative pathology, were at least 60 years of age, and had a reasonable postoperative prognosis. Extensive evaluations took place at 4 to 6 months and 12 to 14 months after surgery, including five different visual acuity measurements and contrast sensitivity. All testing was completed on both eyes. Data from the fellow eye served as a control when implanted with a monofocal IOL. Overall uncorrected distance visual acuity at 1 year after surgery shows 57% patients with 20/40 or better acuity. In this same group, 78% achieved J3 or better near vision, which improved to 82% in the best case group. Uncorrected visual acuity of 20/40 or better and J3 or better was achieved by 50% of best case multifocal IOL patients, compared with 26% of the monofocal best case comparison group. Measurements of contrast sensitivity consistently document a small loss, which is considered clinically insignificant. Statistical analysis of satisfaction ratings shows that predictors of satisfaction include uncorrected distance acuity, final near acuity, and fellow eye spherical equivalent. This multifocal lens appears to work very well for most patients, with more than half having functional uncorrected distance and near vision. The study showed several considerations that are important for optimizing clinical performance and patient satisfaction: patient selection, realistic expectations, accurate biometry, and adequate control of surgical procedures.

  3. Variation of stemness markers expression in tumor nodules from synchronous multi-focal hepatocellular carcinoma - an immunohistochemical study.

    Science.gov (United States)

    Lo, Regina Cheuk-Lam; Leung, Carmen Oi-Ning; Chok, Kenneth Siu-Ho; Ng, Irene Oi-Lin

    2017-08-01

    Advancing knowledge in molecular pathogenesis of hepatocellular carcinoma (HCC) opens up new horizons in the diagnostic, prognostic and therapeutic perspectives. Assessing the expression of molecular targets prior to definitive treatment is gaining importance in clinical practice. In this study, we investigated the variation in expression pattern of stemness markers in synchronous multi-focal HCC. In the first cohort, 21 liver explants with multi-focal HCC were examined for expression of stemness markers EpCAM, Sox9 and CK19 by immunohistochemistry (IHC). Expression data of 50 tumor nodules were analyzed to determine the concordance of expression among nodules in the same livers. In the second cohort, 14 tumor nodules from 6 multi-focal HCC cases proven as intra-hepatic metastasis were examined for Soc9 immunoexpression. In the first cohort, thirty nodules from 16 cases expressed one or more markers, with Sox9 being most frequently expressed. Complete concordance of expression pattern for all 3 markers was observed in 6 cases. Discrepancy of staining degree was noted in 4 cases for EpCAM, 14 cases for Sox9, and 6 cases for CK19. A two-tier or three-tier difference in staining scores was noted in 5 cases for Sox9 and one case for CK19. With Sox9, identical tumor morphology in terms of Edmondson grading and growth pattern did not infer the same degree of immunoexpression; and the largest tumor nodule was not representative of highest IHC score. In the second cohort of intra-hepatic metastasis, complete concordance of Sox9 expression level was observed in 5 out of 6 cases; while the remaining case showed a 1-tier difference of positive staining. Our findings suggested that clonality of tumor nodules is apparently an important factor to infer immunoexpression pattern. When there is limited information to discern multiple primaries versus intra-hepatic metastasis in multi-focal HCC, discordant degree of stemness markers expression among tumor nodules was commonly

  4. Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO): Role of imaging in diagnosis

    International Nuclear Information System (INIS)

    Thakur, Uma; Blacksin, Marcia; Beebe, Kathleen; Neilson, J.C.; Dashefsky, Barry; Tagoylo, Gino

    2012-01-01

    There is a spectrum of musculoskeletal disorders which can be associated with dermatologic findings, the fundamental component of which is a nonbacterial osteitis. CRMO (Chronic recurrent multifocal osteomyelitis) and SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) describe paediatric and adult conditions, respectively, of inflammatory osteitis that can be associated with palmoplantar pustulosis and acne. Imaging findings are similar and a key component to the diagnosis in both conditions. This report describes two patients with strikingly similar radiologic presentations of clavicular osteitis in whom the diagnosis was made predominantly on the basis of imaging findings. The typical imaging features and radiographic hallmarks of both conditions will also be discussed.

  5. Near-point string: Simple method to demonstrate anticipated near point for multifocal and accommodating intraocular lenses.

    Science.gov (United States)

    George, Monica C; Lazer, Zane P; George, David S

    2016-05-01

    We present a technique that uses a near-point string to demonstrate the anticipated near point of multifocal and accommodating intraocular lenses (IOLs). Beads are placed on the string at distances corresponding to the near points for diffractive and accommodating IOLs. The string is held up to the patient's eye to demonstrate where each of the IOLs is likely to provide the best near vision. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. The Benefit of Mirtazapine in the Treatment of Progressive Multifocal Leukoencephalopathy in a Young HIV-positive Patient

    Science.gov (United States)

    Miranda, Jorge; Sandoval, Hugo; Ramos-Duran, Luis; Tonarelli, Silvina B.

    2018-01-01

    Highly active antiretroviral therapy is well-established in the treatment of human immunodeficiency virus (HIV)-positive patients. Nonadherence with therapy regimens often leads to the occurrence of opportunistic infections that further complicate treatment and challenge the treating physician. We report a young HIV-positive patient who suffered from progressive multifocal leukoencephalopathy caused by the human John Cunningham virus and showed objective clinical improvement after adding mirtazapine to the treatment regimen, an observation that is supported by the emerging literature. PMID:29497578

  7. Magnetic resonance imaging may simulate progressive multifocal leucoencephalopathy in a patient with chronic lymphocytic leukemia after fludarabine therapy

    Directory of Open Access Journals (Sweden)

    Kalita J

    2008-01-01

    Full Text Available A 60-year-old male with chronic lymphatic leukemia (CLL after 6 months of fludarabine therapy was admitted with status epilepticus and developed left hemiplegia. His magnetic resonance imaging revealed multiple T2 hyperintense lesions in the right frontal and left parieto-occipital lesion, simulating progressive multifocal leucoencephalopathy (PML. Cerebrospinal fluid Polymerase Chain Reaction (PCR for JC virus was negative. We suggest the possible role of fludarabine in producing PML-like lesions in patients with Chronic Lymphocytic Leukemia (CLL.

  8. Spectacle Independence after Cataract Extraction in Post-Radial Keratotomy Patients Using Hybrid Monovision with ReSTOR® Multifocal and TECNIS® Monofocal Intraocular Lenses

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    Isha Gupta

    2014-05-01

    Full Text Available Background: We report 2 patients who have undergone radial keratotomy (RK preceding ReSTOR® multifocal intraocular lens (IOL; Alcon, Fort Worth, Tex., USA implantation in their nondominant eyes and TECNIS® monofocal IOL (Abbott Medical Optics, Abbott Park, Ill., USA in their dominant eyes. Methods: Retrospective review of 2 patients who underwent hybrid monovision with ReSTOR® multifocal and TECHNIS® monofocal IOLs at the time of cataract surgery after a remote history of RK. Results: Implantation of the ReSTOR® multifocal and the TECHNIS® monofocal IOLs was successful, with no reported adverse events. The patients were able to achieve spectacle freedom. Conclusion: We report a novel technique for the management of post-RK patients to optimize their chances for spectacle independence.

  9. Bilateral implantation of +3.0 D multifocal toric intraocular lenses: results of a US Food and Drug Administration clinical trial.

    Science.gov (United States)

    Lehmann, Robert; Modi, Satish; Fisher, Bret; Michna, Magda; Snyder, Michael

    2017-01-01

    The purpose of this study was to evaluate the clinical outcomes of apodized diffractive +3.0 D multifocal toric intraocular lens (IOL) implantations in subjects with preoperative corneal astigmatism. This was a prospective cohort study conducted at 21 US sites. The study population consisted of 574 subjects, aged ≥21 years, with preoperative astigmatism 0.75-2.82 D, and potential postoperative visual acuity (VA) ≥0.2 logMAR, undergoing bilateral cataract removal by phacoemulsification. The intervention was bilateral implantation of aspheric apodized diffractive +3.0 D multifocal toric or spherical multifocal nontoric IOLs. The main outcome measures were monocular uncorrected near and distance VA and safety at 12 months. A total of 373/386 and 182/188 subjects implanted with multifocal toric and nontoric IOLs, respectively, completed 12-month follow-up after the second implantation. Toric IOLs were nonin-ferior in monocular uncorrected distance (4 m) and near (40 cm) VA but had >1 line better binocular uncorrected intermediate VA (50, 60, and 70 cm) than nontoric IOLs. Toric IOLs reduced cylinder to within 0.50 D and 1.0 D of target in 278 (74.5%) and 351 (94.1%) subjects, respectively. Mean ± standard deviation (SD) differences between intended and achieved axis orientation in the first and second implanted eyes were 5.0°±6.1° and 4.7°±4.0°, respectively. Mean ± SD 12-month IOL rotations in the first and second implanted eyes were 2.7°±5.8° and 2.2°±2.7°, respectively. No subject receiving toric IOLs required secondary surgical intervention due to optical lens properties. Multifocal toric IOLs were noninferior to multifocal nontoric IOLs in uncorrected distance and near VAs in subjects with preexisting corneal astigmatism and effectively corrected astigmatism of 0.75-2.82 D.

  10. Paracoccidioidomicose crônica multifocal tendo como primeira manifestação o envolvimento palpebral: relato de caso Chronical and multifocal paracoccidioidomycosis having the lid involvement as the first sign: case report

    Directory of Open Access Journals (Sweden)

    Tiago Nelson de Oliveira Rassi

    2009-12-01

    Full Text Available O acometimento ocular da paracoccidioidomicose é raro e quando ocorre é geralmente secundário à disseminação hematogênica. Descrição de um caso de paracococcidioidomicose multifocal em homem de 73 anos com história de trauma contuso no olho direito por pedaço de madeira e que teve como primeira manifestação clínica lesão palpebro-conjuntival. Interroga-se possível infecção primária ocular por contiguidade e alerta-se para a manifestação da doença em idade mais avançada.Ocular involvement of paracoccidioidomycosis is rare and when it occurs it is usually secondary to hematogenic dissemination. A case of multifocal paracoccidioidomycosis in a 73 year-old male after history of blunt trauma in the right eye with a stick of wood that presented as the first clinical sign a lid-conjunctival lesion is described. The possible primary ocular infection spreading by contiguity is argued and the disease manifestation in an advanced age is highlighted.

  11. HMB-45 negative multifocal malignant perivascular epithelioid cell tumor of the soft tissue responding to sirolimus: First case report from India.

    Science.gov (United States)

    Kapoor, Akhil; Beniwal, Surender; Singhal, Mukesh Kumar; Kumar, Narender; Kumar, Vanita; Kumar, Harvindra Singh

    2015-01-01

    Perivascular epithelioid cell tumor (PEComa) is a group of sarcomas that exhibit a myomelanocytic phenotype and possess a unique cell type in the perivascular epithelioid cell. Traditionally HMB-45 immunoreactivity is the first criteria required to consider a tumor to be PEComa. We report a case of multifocal PEComa with negative HMB-45 marker. The patient presented with three big ulceroproliferative lesions; two over right thigh and one over the scalp in the right frontal region. The patient was prescribed with oral sirolimus to which good response was seen. To the best of our knowledge, this is the first case of HMB-45 negative multifocal malignant PEComa from India.

  12. Avaliação da composição molecular da cápsula anterior da lente de cães idosos com catarata de alto risco

    Directory of Open Access Journals (Sweden)

    Ana Paula Hvenegaard

    Full Text Available Resumo: Atualmente, a cápsula anterior e o epitélio da lente tem sido cada vez mais estudados, com o intuito de reduzir as possíveis complicações do pós-operatório da remoção da catarata, tal como a opacidade da cápsula posterior, alteração ocasionada principalmente pela diferenciação e migração das células do epitélio lenticular para a cápsula posterior da lente. O objetivo deste estudo foi analisar a composição molecular da cápsula anterior da lente pela técnica histoquímica de PAS (avaliação de proteoglicanos e picrosirius red (avaliação de colágeno IV, em cães idosos com catarata diabética e não diabética do tipo hipermadura, submetidos ao uso ou não de azul de tripano a 0,1 % durante a facoemulsificação. Vinte e sete cães foram estudados, incluindo 21 fêmeas e 6 machos, de 8 a 12 anos de idade (média = 9,6 anos, de diversas raças e divididos em 2 grupos: GC (catarata hipermadura e GCD (catarata diabética. Os resultados das análises realizadas mostraram que ambas as amostras, tanto as provenientes das cataratas hipermaduras, quanto das diabéticas, apresentam semelhante composição molecular de proteoglicanos e colágeno IV e isto independente da utilização de azul de tripano a 0,1 %. Conclui-se, portanto, que se os resultados obtidos forem decorrentes de alterações provocadas pelo rápido metabolismo da catarata diabética e pela cronicidade da catarata hipermadura sugere-se que o comprometimento da estrutura capsular seja de intensidade equivalente e, por consequência, que isto também possa prejudicar o metabolismo das células do epitélio anterior da lente, diminuindo assim a incidência da opacidade da cápsula posterior de cães com catarata diabética e hipermadura submetidos à facoemulsificação.

  13. Avaliação da qualidade óptica de lentes de contato gelatinosas na correção de miopia Evaluation of optical performance of soft contact lenses in myopic correction

    Directory of Open Access Journals (Sweden)

    Marcelo Weslley Dalcoll

    2008-12-01

    Full Text Available OBJETIVO: Avaliar a qualidade óptica de olhos adaptados com dois tipos diferentes de lentes de contato gelatinosas: Acuvue® 2 (Vistacon J&J Vision Care Inc., EUA e World Vision Disposable Asférica Wave Front® (World Vision Ophthalmic, Brasil. MÉTODOS: Estudo clínico e prospectivo com intervenção em amostra constituída por 40 indivíduos portadores de miopia entre -0,75D e -4,50D, sem ou com astigmatismo até -0,75D. Um olho de cada paciente foi sorteado para avaliação a qual incluiu acuidade visual de alto e baixo contraste, aberrometria e teste de sensibilidade ao contraste. RESULTADOS: A sobre-refração objetiva realizada pelo Nidek OPD-Scan detectou hipercorreção significativa para ambas as lentes de contato gelatinosas. A avaliação da AV logMAR de alto e baixo contraste mostrou diferença significativa favorável das lentes de contato gelatinosas em relação aos óculos e na comparação entre as lentes de contato gelatinosas, apenas em relação à AV logMAR de alto contraste, houve melhor desempenho da LC World Vision Disposable Asférica Wave Front® . A avaliação de sensibilidade ao contraste detectou melhor desempenho das lentes de contato gelatinosas em relação aos óculos para as freqüências espaciais de 1,5; 3; 6 e 18. Não houve diferença significativa entre os dois tipos de lentes de contato gelatinosas nas freqüências espaciais avaliadas. A análise de frentes de onda não identificou diferença significativa do índice de Strehl, função de transferência modular (MTF e das aberrações de alta ordem (aberrações totais, coma, trefoil, quadrifoil, esférica e astigmatismo secundário sem e com as lentes de contato gelatinosas, bem como na comparação entre elas. CONCLUSÃO: Houve melhor desempenho óptico da lente de contato gelatinosa World Vision Disposable Asférica Wave Front® na medida de AV logMAR de alto contraste. Não houve diferença entre as lentes de contato gelatinosas nas avalia

  14. Bilateral Acanthamoeba ulcer in a user of disposable soft contact lenses: a tragic incident or a consequence of the aggressive policy of soft contact lens trading? Úlcera bilateral por Acanthamoeba em usuária de lentes de contato gelatinosas descartáveis: um incidente trágico ou uma conseqüência da política agressiva de venda de lentes de contato gelatinosas?

    Directory of Open Access Journals (Sweden)

    Sidney Júlio de Faria e Sousa

    2008-06-01

    Full Text Available This is the report of a case of bilateral Acanthamoeba keratitis in a 19-year-old woman who bought a pair of disposable soft contact lenses in a boutique. She wore this same pair of lenses for 3 months daily without the appropriate care. This led to bilateral corneal transplantation with cataract extraction and also trabeculectomy in the right eye. When last seen, both grafts were crystal clear but the visual acuities were far from satisfactory. She also had bilateral secondary glaucoma, barely controlled by topical medication. Actually, the physical features and the wearing time characteristics of the disposable soft contact lenses created unprecedented difficulties to the medical surveillance of their wearers. Without the right assistance they tend to become careless regarding routine cleaning. They also feel free to buy less expensive lenses, to use saline instead of lens solutions, to violate the limits of wearing time and to extend the use over the sleeping period. Additionally, the aggressive marketing and the wide distribution of these lenses increase the chances that economically or educationally unprepared people will acquire them. The question that remains is: Is the present case an accidental event or an example of what is likely to happen in the future if the indiscriminate selling of disposable soft contact lenses continues to evolve?Este é o relato de uma paciente do sexo feminino, de 19 anos, com ceratite bilateral por Acanthamoeba, devido ao uso de lentes de contato descartáveis, adquiridas em uma butique. Fez uso do mesmo par de lentes durante três meses, sem os cuidados adequados. Foi submetida a transplante penetrante de córnea e facectomia bilateral, além de trabeculectomia no olho direito. Quando vista pela última vez, os enxertos estavam transparentes, mas a visão de ambos os olhos não era satisfatória. Ela também apresentava glaucoma secundário bilateral, controlado precariamente com medicação tópica. Ocorre

  15. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    International Nuclear Information System (INIS)

    Gotthardt, M.; Philipps Univ., Marburg; Rubner, C.; Bauhofer, A.

    2006-01-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76±80.6 Gy versus 125.6±46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2±101.7 Gy versus 125.6±46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  16. Successful treatment of chronic recurrent multifocal osteomyelitis using low-dose radiotherapy. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Dietzel, Christian T.; Vordermark, Dirk [Klinikum der Martin-Luther-Universitaet Halle-Wittenberg, Universitaetslinik und Poliklinik fuer Strahlentherapie, Halle (Saale) (Germany); Schaefer, Christoph [Klinikum der Martin-Luther-Universitaet Halle-Wittenberg, Universitaetsklinik und Poliklinik fuer Innere Medizin II, Halle (Saale) (Germany)

    2017-03-15

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, which lacks an infectious genesis and predominantly involves the metaphysis of long bones. Common treatments range from nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids at first onset of disease, to immunosuppressive drugs and bisphosphonates in cases of insufficient remission. The therapeutic use of low-dose radiotherapy for CRMO constitutes a novelty. A 67-year-old female patient presented with radiologically proven CRMO affecting the right tibia/talus and no response to immunosuppressive therapy. Two treatment series of radiation therapy were applied with an interval of 6 weeks. Each series contained six fractions (three fractions per week) with single doses of 0.5 Gy, thus the total applied dose was 6 Gy. Ten months later, pain and symptoms of osteomyelitis had completely vanished. Radiotherapy seems to be an efficient and feasible complementary treatment option for conventional treatment refractory CRMO in adulthood. The application of low doses per fraction is justified by the inflammatory pathomechanism of disease. (orig.) [German] Die chronisch rekurrierende multifokale Osteomyelitis (CRMO) ist eine seltene autoimmunologische Erkrankung und befaellt vorzugsweise die Metaphysen der langen Roehrenknochen. Die Therapie umfasst nichtsteroidale Antirheumatika (NSAIDs) und Kortikosteroide bei Erstbefall und reicht bis hin zu Immunsuppressiva und Bisphosphonaten bei insuffizientem Ansprechen. Die Anwendung einer niedrigdosierten Radiatio stellt ein therapeutisches Novum dar. Eine 67-jaehrige Patientin stellte sich mit einem radiologisch gesicherten Befall im Sinne einer CRMO im Bereich des rechten Talus und der Tibia vor. Eine initiale Behandlung mit Immunsuppressiva verblieb erfolglos. Wir fuehrten zwei Bestrahlungsserien im Intervall von 6 Wochen durch. Jede Serie bestand aus 6 Fraktionen (3 Fraktionen/Woche), mit einer Einzeldosis von jeweils 0,5 Gy. Die

  17. Immune Reconstitution Inflammatory Syndrome Unmasking or Worsening AIDS-Related Progressive Multifocal Leukoencephalopathy: A Literature Review

    Directory of Open Access Journals (Sweden)

    Anna Fournier

    2017-05-01

    Full Text Available Incidence of progressive multifocal leukoencephalopathy (PML in HIV-infected patients has declined in the combined antiretroviral therapy (cART era although a growing number of acquired immunodeficiency syndrome (AIDS-related PML-immune reconstitution inflammatory syndromes (PML-IRIS have been published during the same period. Therapeutic management of PML-IRIS is not consensual and mainly relies on corticosteroids. Our main aim was, in addition to provide a thoughtful analysis of published PML-IRIS cases, to assess the benefit of corticosteroids in the management of PML-IRIS, focusing on confirmed cases. We performed a literature review of the 46 confirmed cases of PML-IRIS cases occurring in HIV-infected patients from 1998 to September 2016 (21 unmasking and 25 paradoxical PML-IRIS. AIDS-related PML-IRIS patients were mostly men (sex ratio 4/1 with a median age of 40.5 years (range 12–66. Median CD4 T cell count before cART and at PML-IRIS onset was 45/μl (0–301 and 101/μl (20–610, respectively. After cART initiation, PML-IRIS occurred within a median timescale of 38 days (18–120. Clinical signs were motor deficits (69%, speech disorders (36%, cognitive disorders (33%, cerebellar ataxia (28%, and visual disturbances (23%. Brain MRI revealed hyperintense areas on T2-weighted sequences and FLAIR images (76% and suggestive contrast enhancement (87%. PCR for John Cunningham virus (JCV in cerebrospinal fluid (CSF was positive in only 84% of cases; however, when performed, brain biopsy confirmed diagnosis of PML in 90% of cases and demonstrated histological signs of IRIS in 95% of cases. Clinical worsening related to PML-IRIS and leading to death was observed in 28% of cases. Corticosteroids were prescribed in 63% of cases and maraviroc in one case. Statistical analysis failed to demonstrate significant benefit from steroid treatment, despite spectacular improvement in certain cases. Diagnosis of PML-IRIS should be considered in HIV

  18. Immune Reconstitution Inflammatory Syndrome Unmasking or Worsening AIDS-Related Progressive Multifocal Leukoencephalopathy: A Literature Review.

    Science.gov (United States)

    Fournier, Anna; Martin-Blondel, Guillaume; Lechapt-Zalcman, Emmanuèle; Dina, Julia; Kazemi, Apolline; Verdon, Renaud; Mortier, Emmanuel; de La Blanchardière, Arnaud

    2017-01-01

    Incidence of progressive multifocal leukoencephalopathy (PML) in HIV-infected patients has declined in the combined antiretroviral therapy (cART) era although a growing number of acquired immunodeficiency syndrome (AIDS)-related PML-immune reconstitution inflammatory syndromes (PML-IRIS) have been published during the same period. Therapeutic management of PML-IRIS is not consensual and mainly relies on corticosteroids. Our main aim was, in addition to provide a thoughtful analysis of published PML-IRIS cases, to assess the benefit of corticosteroids in the management of PML-IRIS, focusing on confirmed cases. We performed a literature review of the 46 confirmed cases of PML-IRIS cases occurring in HIV-infected patients from 1998 to September 2016 (21 unmasking and 25 paradoxical PML-IRIS). AIDS-related PML-IRIS patients were mostly men (sex ratio 4/1) with a median age of 40.5 years (range 12-66). Median CD4 T cell count before cART and at PML-IRIS onset was 45/μl (0-301) and 101/μl (20-610), respectively. After cART initiation, PML-IRIS occurred within a median timescale of 38 days (18-120). Clinical signs were motor deficits (69%), speech disorders (36%), cognitive disorders (33%), cerebellar ataxia (28%), and visual disturbances (23%). Brain MRI revealed hyperintense areas on T2-weighted sequences and FLAIR images (76%) and suggestive contrast enhancement (87%). PCR for John Cunningham virus (JCV) in cerebrospinal fluid (CSF) was positive in only 84% of cases; however, when performed, brain biopsy confirmed diagnosis of PML in 90% of cases and demonstrated histological signs of IRIS in 95% of cases. Clinical worsening related to PML-IRIS and leading to death was observed in 28% of cases. Corticosteroids were prescribed in 63% of cases and maraviroc in one case. Statistical analysis failed to demonstrate significant benefit from steroid treatment, despite spectacular improvement in certain cases. Diagnosis of PML-IRIS should be considered in HIV

  19. Rotationally asymmetric multifocal IOL implantation with and without capsular tension ring: refractive and visual outcomes and intraocular optical performance.

    Science.gov (United States)

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P

    2012-04-01

    To ascertain whether the refractive, visual, and intraocular optical quality outcomes of a rotationally asymmetric multifocal intraocular lens (IOL) are enhanced by the use of a capsular tension ring. Ninety consecutive eyes from 53 patients (age range: 36 to 82 years) were divided into two groups: the no ring group comprised 43 eyes implanted with the multifocal rotationally asymmetric Lentis Mplus LS-312 (Oculentis GmbH) without a capsular tension ring; and the ring group comprised 47 eyes with the same IOL with a capsular tension ring. Distance and near visual acuity and refractive outcomes were evaluated pre- and postoperatively. Contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively. Significant postoperative differences between groups were found in sphere, spherical equivalent refraction, and near addition (P<.02). Regarding defocus curve, significantly better visual acuity was present in eyes with the capsular tension ring for intermediate vision conditions (P<.05). Intraocular aberrometry did not differ significantly between groups (P<.09). Refractive predictability and intermediate visual outcomes with the Lentis Mplus LS-312 IOL improved significantly when implanted in combination with a capsular tension ring. Copyright 2012, SLACK Incorporated.

  20. Idiopathic multifocal choroiditis/punctate inner choroidopathy with acute photoreceptor loss or dysfunction out of proportion to clinically visible lesions

    Science.gov (United States)

    Munk, Marion R.; Jung, Jesse J.; Biggee, Kristin; Tucker, William R.; Sen, H. Nida; Schmidt-Erfurth, Ursula; Fawzi, Amani A.; Jampol, Lee M.

    2014-01-01

    Purpose To report acute/subacute vision loss and paracentral scotomata in patients with idiopathic multifocal choroiditis/punctate inner choroidopathy (MFC/PIC) due to large zones of acute photoreceptor attenuation surrounding the chorioretinal lesions. Methods Multimodal-imaging case-series Results Six females and 2 males were included (mean age 31.5±5.8 years). Vision ranged from 20/20-1 to hand motion (mean 20/364). SD-OCT demonstrated extensive attenuation of the external limiting membrane (ELM), ellipsoid and interdigitation zones, adjacent to the visible MFC/PIC lesions. The corresponding areas were hyperautofluorescent on fundus-autofluorescence (FAF), and were associated with corresponding visual field defects. Full-field ERG (available in 3 cases) showed markedly decreased cone/rod response and multifocal ERG revealed reduced amplitudes and increased implicit times in 2 cases. Three patients received no treatment, the remaining were treated with oral corticosteroids (n=4), oral acyclovir/valacyclovir (n=2), intravitreal/posterior subtenon triamcinolone-acetate (n=3) and anti-VEGF (n=2). Visual recovery occurred in only 3 cases, of whom 2 were treated. Varying morphological recovery was found in 6 cases, associated with decrease in hyperautofluorescence on FAF. Conclusions MFC/PIC can present with transient or permanent central photoreceptor attenuation/loss. This presentation is likely a variant of MFC/PIC with chorioretinal atrophy. Associated changes are best evaluated using multimodal imaging. PMID:25322466

  1. Development of a slow mono-kinetic electron source; Etude et realisation d'une source d'electrons lents monocinetiques

    Energy Technology Data Exchange (ETDEWEB)

    Ballu, Y [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1968-06-01

    A comparative study of already existing slow mono-kinetic electron guns shows that those using a 127 degrees electrostatic selector can be improved still further to arrive at the performances obtained with spherical 180 degrees selectors for example. For this reason we have examined the 127 degrees selector theoretically in more detail; it appears that it should be possible to obtain a resolving power better than 30 mV for a current of about 10{sup -10} A, on condition that certain improvements be made to the instrument as normally designed, in particular concerning the entrance and exit slides. As a result, the usual suppressors for the scattered electrons are no longer necessary. The development of this apparatus has been carried out with particular care: the dimensional characteristics are fixed to an accuracy of a few microns, although the instrument can be baked out at 300 C. The experimental results are in excellent agreement with the theoretical predictions: for a current of 10{sup -10} A, the measured resolving power is 24 {+-} 4 mV. The easy detection of the He{sup -} resonance line at 19.3 eV has confirmed the advantages of this apparatus for the study of atomic collisions. (author) [French] L'etude comparative des canons a electrons lents monocinetiques realises jusqu'a present montre que ceux qui utilisent un selecteur electrostatique a 127 degres peuvent etre encore perfectionnes en vue de parvenir aux performances obtenues avec les selecteurs spheriques a 180 degres par exemple. D'ou notre etude theorique approfondie du selecteur a 127 degres qui nous a conduit a esperer une resolution meilleure que 30 mV pour un courant de l'ordre de 10{sup -10} A a condition d'apporter certaines ameliorations a la conception usuelle de cet instrument notamment au niveau des fentes d'entree et de sortie. Par voie de consequence les suppresseurs habituels d'electrons parasites deviennent inutiles. L'etude et la mise au point de l'appareil ont fait l'objet de soins

  2. Estudo das capacidades organizacionais sob a lente da ambidestria: uma abordagem a partir do ponto de vista estratégico

    Directory of Open Access Journals (Sweden)

    Diego Jacob Kurtz

    2013-11-01

    Full Text Available O presente trabalho alinha-se à visão de que a criação de riqueza em regimes de rápida mudança depende em grande medida da capacidade de aperfeiçoar tecnologias, processos e a gestão interna da empresa. Isso é permitido na medida em que a organização equilibra suas capacidades referentes à eficácia e eficiência de suas operações (explotação àquelas ligadas às novas formas de negócio e exploração de oportunidades (exploração. O objetivo desta pesquisa consiste na realização de uma busca e análise sistemática da literatura que aborda as capacidades das organizações sob a lente da ambidestria e orientação estratégica em ambientes de elevada turbulência. A sessão de resultados apresenta as principais abordagens referentes às capacidades de exploração e explotação dos recursos e orientação estratégica. Apresenta-se também uma análise a respeito de como o ambiente modera e influencia a utilização desses recursos em contextos de rápida mudança e elevada instabilidade. Identificou-se que parte das pesquisas não expõe de forma clara a relação entre a ambidestria e outros constructos. Quando associados aos termos relacionados a ambientes turbulentos, muitas vezes são utilizados apenas de forma superficial, servindo somente de contexto para o estudo; em outras vezes, é abordado de forma mais ativa, sendo apresentado como moderador direto sobre as variáveis analisadas. Novos trabalhos devem considerar a ambidestria organizacional no curto prazo e suas respectivas implicações de desempenho no longo prazo. Existe ainda a necessidade de criar uma visão mais dinâmica de como organizações ambidestras adaptam-se às mudanças, considerando o impacto sobre a orientação estratégica em diferentes contextos. 

  3. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lee Bonsan B

    2009-03-01

    Full Text Available Abstract Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use or a control group (usual care. The primary outcome measure will be falls (measured with 13 monthly calendars. Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855.

  4. The Effects of Hashimoto Thyroiditis on Lymph Node Metastases in Unifocal and Multifocal Papillary Thyroid Carcinoma: A Retrospective Chinese Cohort Study.

    Science.gov (United States)

    Zhu, Feng; Shen, Yi Bin; Li, Fu Qiang; Fang, Yun; Hu, Liang; Wu, Yi Jun

    2016-02-01

    The purpose of this study was to investigate the risk factors for central and lateral neck lymph node metastases in papillary thyroid carcinoma (PTC) and multifocal papillary thyroid carcinoma (MPTC), particularly when associated with Hashimoto thyroiditis (HT).A retrospective analysis of 763 consecutive patients who underwent total thyroidectomy with bilateral central neck dissection in the First Affiliated Hospital, College of Medicine, Zhejiang University between October 2011 and October 2014 was conducted. All patients had formal histological diagnoses of HT. Multivariable logistic regression analysis was performed to identify risk factors of neck lymph node metastases.Our study identified 277 PTC patients with HT and showed comparatively low rates of central lymph node metastases (CLNM) compared with the PTC patients without HT (37.2% versus 54.7%, P thyroid peroxidase antibody >140 IU/mL was established as the most sensitive and specific level for the prediction of MPTC based on receiver operating characteristic curve analyses. Thyroid peroxidase antibody, age, tumor size, and multifocality exhibited the ability to predict CLNM in PTC with HT patients with an area under the curve of 81.1% based on a multivariate model.Hashimoto thyroiditis was associated with increased prevalences of multifocality and capsular invasion. In contrast, HT was associated with a reduced risk of CLNM in PTC and MPTC patients, which indicated a potential protective effect. We found that the prognostic prediction model was applicable for predicting multifocality and CLNM in PTC patients with HT.

  5. Objective perimetry using a four-channel multifocal VEP system: correlation with conventional perimetry and thickness of the retinal nerve fibre layer.

    Science.gov (United States)

    Horn, Folkert K; Kaltwasser, Christoph; Jünemann, Anselm G; Kremers, Jan; Tornow, Ralf P

    2012-04-01

    There is evidence that multifocal visual evoked potentials (VEPs) can be used as an objective tool to detect visual field loss. The aim of this study was to correlate multifocal VEP amplitudes with standard perimetry data and retinal nerve fibre layer (RNFL) thickness. Multifocal VEP recordings were performed with a four-channel electrode array using 58 stimulus fields (pattern reversal dartboard). For each field, the recording from the channel with maximal signal-to-noise ratio (SNR) was retained, resulting in an SNR optimised virtual recording. Correlation with RNFL thickness, measured with spectral domain optical coherence tomography and with standard perimetry, was performed for nerve fibre bundle related areas. The mean amplitudes in nerve fibre related areas were smaller in glaucoma patients than in normal subjects. The differences between both groups were most significant in mid-peripheral areas. Amplitudes in these areas were significantly correlated with corresponding RNFL thickness (Spearman R=0.76) and with standard perimetry (R=0.71). The multifocal VEP amplitude was correlated with perimetric visual field data and the RNFL thickness of the corresponding regions. This method of SNR optimisation is useful for extracting data from recordings and may be appropriate for objective assessment of visual function at different locations. This study has been registered at http://www.clinicaltrials.gov (NCT00494923).

  6. Fixation stability and implication for multifocal electroretinography in patients with neovascular age-related macular degeneration after anti-VEGF treatment

    DEFF Research Database (Denmark)

    Pedersen, Karen Bjerg; Sjølie, Anne Katrin; Vestergaard, Anders Højslet

    2016-01-01

    Purpose: To quantify fixation stability in patients with neovascular age-related macular degeneration (nAMD) at baseline, 3 and 6 months after anti-vascular endothelial growth factor (anti-VEGF) treatment and furthermore asses the implications of an unsteady fixation for multifocal...

  7. Late toxicity results of the GORTEC 94-01 randomized trial comparing radiotherapy with concomitant radiochemotherapy for advanced-stage oropharynx carcinoma: comparison of LENT/SOMA, RTOG/EORTC, and NCI-CTC scoring systems

    International Nuclear Information System (INIS)

    Denis, Fabrice; Garaud, Pascal; Bardet, Etienne; Alfonsi, Marc; Sire, Christian; Germain, Thierry; Bergerot, Philippe; Rhein, Beatrix; Tortochaux, Jacques; Oudinot, Patrick; Calais, Gilles

    2003-01-01

    Purpose: To prospectively assess 5-year late toxicity in patients treated by concomitant radiochemotherapy for locally advanced oropharynx carcinoma using three different toxicity scales. Methods and Materials: A total of 226 patients were entered in a Phase III multicenter, randomized trial comparing radiotherapy alone (70 Gy in 35 fractions: Arm A) with concomitant radiochemotherapy (70 Gy in 35 fractions with three cycles of a 4-day regimen containing carboplatin and 5-fluorouracil: Arm B). Five living patients, free of local or distant recurrences, could not be evaluated for late toxicity. Forty-four patients were eligible for late toxicity with a median follow-up of 5 years. Late toxicity was evaluated by the radiation oncologist using a large questionnaire containing 120 mixed items of three scales (NCI-CTC, LENT/SOMA, and RTOG). The data were then transposed on separate scales using corresponding grades. Results: The 5-year overall survival rate was 22% in Arm B and 16% in Arm A (p=0.05). The 5-year locoregional control rate was 48% in Arm B and 25% in Arm A (p=0.002). The spinal cord was not affected by the concomitant adjunct of chemotherapy, and no deaths were caused by late toxicity. Using the three late toxicity scales, 100% of the patients treated with the combined modality (Arm B) developed one or more late complications vs. 94% in the radiotherapy-alone arm (Arm A). The difference was not statistically significant. The most commonly damaged organs (all Grade 1-4) were the salivary glands (100% in Arm B vs. 82% in Arm A, p<0.05), skin (78% vs. 47%, p<0.05), teeth (67% vs. 18%, p<0.05), mucosa (59% vs. 63% p = not significant), and mandible (44% vs. 12%, p<0.05). One or more Grade 3-4 complications occurred in 82% of the patients in Arm B vs. 47% in Arm A (p=0.02) but concerned only the teeth. The correlation between the RTOG and LENT/SOMA scale and between the NCI-CTC and LENT/SOMA scale were low for Grade 1-4 toxicity (near 30%). The transposability

  8. Multifocal diffusion of KPC-3-producing ST512 Klebsiella pneumoniae in Italy

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    Aurora Piazza

    2012-03-01

    Full Text Available Introduction. The dissemination of carbapenemase-producing Klebsiella pneumoniae strains is an increasing problem worldwide. KPC ß-lactamases are Ambler class A enzymes mostly plasmid-encoded; their global spread represents a threat to clinical patients care and public health. Multi locus sequence type (ST258 is currently the most spread K. pneumoniae clone associated with KPC enzymes. Here we report the first identification and multifocal spread of KPC-3 producing K. pneumoniae clinical strains belonging to ST512 in Italy. Materials and Methods. Fifty six carbapenem-resistant K. pneumoniae isolates were collected from 7 Italian hospitals during the period June 2009-May 2011. Isolates were obtained from different wards (spinal unit, medicine, hematology, etc. and biological samples (mostly rectal swabs, urine and blood. Species identification and antimicrobial susceptibilities were obtained by NBC46/NM40 Microscan panels (Siemens. MICs values were interpreted according to EUCAST 2011 breakpoints. Modified Hodge test and combined disk test with phenyl-boronic acid (BOR and EDTA were performed.The presence of blaKPC genes were confirmed by PCR and sequencing. A complete characterization of the produced ß-lactamases (BLs was obtained by IEF followed by PCR experiments using primers specific for the detection of blaCTX-M-, blaTEM- and blaSHV type genes. PFGE and multilocus sequence typing (MLST were both used to investigate clonal isolates relatedness. Results. All 56 isolates resulted positive for the presence of KPC-type carbapenemases by both phenotypical and molecular analysis. Fifteen isolates, chosen as representative, were further investigated. Ten out of 15 isolates harboring the blaKPC-2 gene clustered with the known ST258, while the remaining 5/10 belonged to the newly described ST512 and harbored the blaKPC-3 gene. ST512 isolates, from 3/7 hospitals, were collected from rectal swabs (40%, blood (20%, endotracheal aspirate (20% and

  9. Compensating additional optical power in the central zone of a multifocal contact lens forminimization of the shrinkage error of the shell mold in the injection molding process.

    Science.gov (United States)

    Vu, Lien T; Chen, Chao-Chang A; Lee, Chia-Cheng; Yu, Chia-Wei

    2018-04-20

    This study aims to develop a compensating method to minimize the shrinkage error of the shell mold (SM) in the injection molding (IM) process to obtain uniform optical power in the central optical zone of soft axial symmetric multifocal contact lenses (CL). The Z-shrinkage error along the Z axis or axial axis of the anterior SM corresponding to the anterior surface of a dry contact lens in the IM process can be minimized by optimizing IM process parameters and then by compensating for additional (Add) powers in the central zone of the original lens design. First, the shrinkage error is minimized by optimizing three levels of four IM parameters, including mold temperature, injection velocity, packing pressure, and cooling time in 18 IM simulations based on an orthogonal array L 18 (2 1 ×3 4 ). Then, based on the Z-shrinkage error from IM simulation, three new contact lens designs are obtained by increasing the Add power in the central zone of the original multifocal CL design to compensate for the optical power errors. Results obtained from IM process simulations and the optical simulations show that the new CL design with 0.1 D increasing in Add power has the closest shrinkage profile to the original anterior SM profile with percentage of reduction in absolute Z-shrinkage error of 55% and more uniform power in the central zone than in the other two cases. Moreover, actual experiments of IM of SM for casting soft multifocal CLs have been performed. The final product of wet CLs has been completed for the original design and the new design. Results of the optical performance have verified the improvement of the compensated design of CLs. The feasibility of this compensating method has been proven based on the measurement results of the produced soft multifocal CLs of the new design. Results of this study can be further applied to predict or compensate for the total optical power errors of the soft multifocal CLs.

  10. Can ratio of the biggest tumor diameter to total tumor diameter be a new parameter in the differential diagnosis of agressive and favorable multifocal papillary thyroid microcarcinoma?

    Science.gov (United States)

    Tam, Abbas Ali; Özdemir, Didem; Çuhacı, Neslihan; Başer, Hüsniye; Dirikoç, Ahmet; Aydın, Cevdet; Yazgan, Aylin Kılıç; Ersoy, Reyhan; Çakır, Bekir

    2017-02-01

    In this study, we aimed to evaluate the usefulness of a new parameter -ratio of the biggest tumor diameter to total tumor diameter- for the differentiation of agressive and favorable papillary thyroid microcarcinomas (PTMC). The diameter of the biggest tumor focus was taken as the primary tumor diameter. Total tumor diameter was calculated as the sum of the maximal diameter of each lesion. Ratio of primary tumor diameter to total tumor diameter was defined as tumor diameter ratio (TDR). Positive and negative predictive value, sensitivity and specificity of TDR to predict capsular invasion, extrathyroidal extension (ETE) and lymph node metastasis (LNM) were determined. Mean TDR was significantly lower in multifocal PTMC patients with capsular invasion, ETE, lymphovascular invasion and LNM compared to patients without these features. The sensitivities of TDR for the detection of LNM, ETE and capsular invasion were 100%, 100% and 94.2%, respectively. Specificity of TDR was 86.2% for LNM, 88% for ETE and 94.7% for capsular invasion. Best cut off values of TDR that can predict capsular invasion, ETE and LNM in multifocal PTMC were 0.62, 0.57 and 0.56, respectively. Multifocal papillary thyroid carcinoma patients with capsular invasion, ETE and LNM had significantly lower mean TDR when compared to ones without these features. Decreased TDR was associated with capsular invasion, ETE and LNM in patients with multifocal PTMC and PTC. This new parameter might be particularly helpful for the detection of aggressive behavior in multifocal PTMCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. A joint Richardson—Lucy deconvolution algorithm for the reconstruction of multifocal structured illumination microscopy data

    International Nuclear Information System (INIS)

    Ströhl, Florian; Kaminski, Clemens F

    2015-01-01

    We demonstrate the reconstruction of images obtained by multifocal structured illumination microscopy, MSIM, using a joint Richardson–Lucy, jRL-MSIM, deconvolution algorithm, which is based on an underlying widefield image-formation model. The method is efficient in the suppression of out-of-focus light and greatly improves image contrast and resolution. Furthermore, it is particularly well suited for the processing of noise corrupted data. The principle is verified on simulated as well as experimental data and a comparison of the jRL-MSIM approach with the standard reconstruction procedure, which is based on image scanning microscopy, ISM, is made. Our algorithm is efficient and freely available in a user friendly software package. (paper)

  12. Multifocal Gastric Ulcers Caused by Diffuse Large B Cell Lymphoma in a Patient With Significant Weight Loss

    Directory of Open Access Journals (Sweden)

    Mark A. Gromski MD

    2016-12-01

    Full Text Available Primary gastrointestinal (GI lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endoscopic biopsies. Multiple treatment modalities including surgery, radiotherapy, and chemotherapy have been used. Advancements in endoscopic and pathologic technology decrease turnaround time for diagnosis and treatment initiation, thus reducing the need for surgery. Health care providers should maintain a high level of suspicion and consider gastric DLBCL as part of the differential diagnosis, especially in those with warning symptoms such as weight loss and early satiety with abnormal endoscopic findings.

  13. [Topographic mapping of retinal function with a scanning laser ophthalmoscope and multifocal electroretinography using short M-sequences].

    Science.gov (United States)

    Rudolph, G; Bechmann, M; Berninger, T; Kutschbach, E; Held, U; Tornow, R P; Kalpadakis, P; Zol'nikova, I V; Shamshinova, A M

    2001-01-01

    A new method of multifocal electroretinography making use of scanning laser ophthalmoscope with a wavelength of 630 nm (SLO-m-ERG), evoking short spatial visual stimuli on the retina, is proposed. Algorithm of presenting the visual stimuli and analysis of distribution of local electroretinograms on the surface of the retina is based on short m-sequences. Mathematical cross correlation analysis shows a three-dimensional distribution of bioelectrical activity of the retina in the central visual field. In normal subjects the cone bioelectrical activity is the maximum in the macular area (corresponding to the density of cone distribution) and absent in the blind spot. The method detects the slightest pathological changes in the retina under control of the site of stimulation and ophthalmoscopic picture of the fundus oculi. The site of the pathological process correlates with the topography of changes in bioelectrical activity of the examined retinal area in diseases of the macular area and pigmented retinitis detectable by ophthalmoscopy.

  14. Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound

    International Nuclear Information System (INIS)

    Wilkinson, L.S.; Given-Wilson, R.; Hall, T.; Potts, H.; Sharma, A.K.; Smith, E.

    2005-01-01

    AIM: The aim of this study was to evaluate the contribution of bilateral whole-breast ultrasound (BBUS) to the diagnosis and management of women with newly diagnosed breast cancer. METHODS: Over a period of 6 months, 102 women presenting with breast cancer underwent BBUS. Data were collected on clinical findings, radiology, histology and surgical outcome. These women were compared with a control group of 124 women presenting over a similar 6-month period 1 year previously, who had undergone targeted breast ultrasound. RESULTS: Multicentric/multifocal tumours were demonstrated in 35 (34%) of the 102 participants and in 18 (15%) of the 124 controls, a statistically significant difference (Fisher's exact test, p=0.001). Multiple tumours were diagnosed preoperatively in 18% of the study population compared with 8% of the controls, and BBUS identified invasive multifocal/multicentric tumours in significantly more women in the study population (11 versus 1 control) (Fisher's exact test, p=0.019). Contralateral cancer was diagnosed in 4 women in the study population and none in the control population (Fisher's exact test, p=0.040). Surgical review showed that the surgical management changed significantly in 8% (95% confidence interval 4 to 14%) of cases in the study population following BBUS. The increase in the number of women undergoing benign biopsies in the study population (10 versus 5 controls) was not statistically significant (Fisher's exact test, p=0.11). CONCLUSION: BBUS increased the preoperative diagnosis of multiple tumours in women presenting with primary breast cancer, resulting in a management change in 8% of cases

  15. Test-retest variability of multifocal electroretinography in normal volunteers and short-term variability in hydroxychloroquine users

    Directory of Open Access Journals (Sweden)

    Browning DJ

    2014-08-01

    Full Text Available David J Browning,1 Chong Lee2 1Charlotte Eye, Ear, Nose and Throat Associates, 2University of North Carolina – Charlotte, Charlotte, NC, USA Purpose: To determine measurement variability of N1P1 amplitudes and the R1/R2 ratio in normal subjects and hydroxychloroquine users without retinopathy. Design: Retrospective, observational study. Subjects: Normal subjects (n=21 and 44 patients taking hydroxychloroquine (n=44 without retinopathy. Methods: Multifocal electroretinography (mfERG was performed twice in one session in the 21 normal subjects and twice within 1 year in the hydroxychloroquine users, during which time no clinical change in macular status occurred. Main outcome measures: N1P1 amplitudes of rings R1–R5, the R1/R2 ratio, and coefficients of repeatability (COR for these measurements. Results: Values for N1P1 amplitudes in hydroxychloroquine users were reduced compared with normal subjects by the known effect of age, but R1/R2 was not affected by age. The COR for R1–R5 ranged from 43% to 52% for normal subjects and from 43% to 59% for hydroxychloroquine users; for R1/R2 the COR was 29% in normal subjects and 45% in hydroxychloroquine users. Conclusion: mfERG measurements show high test-retest variability, limiting the ability of a single mfERG test to influence a decision to stop hydroxychloroquine; corroborative evidence with a different ancillary test is recommended in a suspicious case. Keywords: multifocal electroretinography, hydroxychloroquine, test-retest variability 

  16. Riedel's thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum.

    Science.gov (United States)

    Dahlgren, Mollie; Khosroshahi, Arezou; Nielsen, G Petur; Deshpande, Vikram; Stone, John H

    2010-09-01

    Riedel's thyroiditis is a chronic fibrosing disorder of unknown etiology often associated with "multifocal fibrosclerosis." IgG4-related systemic disease is characterized by IgG4+ plasma cell infiltration and fibrosis throughout many organs. We hypothesized that Riedel's thyroiditis is part of the IgG4-related systemic disease spectrum. We searched our institution's pathology database using the terms "Riedel's," "struma," "thyroid," and "fibrosis," and identified 3 cases of Riedel's thyroiditis. Riedel's thyroiditis was diagnosed if there was a fibroinflammatory process involving all or a portion of the thyroid gland, with evidence of extension of the process into surrounding tissues. Immunohistochemical stains for IgG4 and IgG were performed. The histopathologic and immunohistochemical features of each involved organ were evaluated. The clinical features of one patient with multiple organ system disease were described. All 3 thyroidectomy samples stained positively for IgG4-bearing plasma cells. One patient had extensive extrathyroidal involvement diagnostic of IgG4-related systemic disease, including cholangitis, pseudotumors of both the lung and lacrimal gland, and a lymph node contiguous to the thyroid that stained intensely for IgG4+ plasma cells. The histologic features of all organs involved were consistent with IgG4-related systemic disease. Patient 3 had 10 IgG4+ plasma cells per high-power field initially, but rebiopsy 2 years later demonstrated no IgG4+ plasma cells. That patient's second biopsy, characterized by fibrosis and minimal residual inflammation, further solidifies the link between IgG4-bearing plasma cells in tissue and the histologic evolution to Riedel's thyroiditis. Riedel's thyroiditis is part of the IgG4-related systemic disease spectrum. In many cases, multifocal fibrosclerosis and IgG4-related systemic disease are probably the same entity.

  17. Influência do astigmatismo corneano na acuidade visual final após implante de AcrySof® ReSTOR®: relato de caso Influence of corneal astigmatism in final visual acuity after implantation of AcrySofTM ReSTOR TM: case report

    Directory of Open Access Journals (Sweden)

    Ricardo de Carvalho Rocha

    2007-12-01

    Full Text Available Atualmente tem-se desenvolvido novos tipos de lentes intra-oculares (LIO que objetivam eliminar a presbiopia e o seu uso vem se popularizando. Descreve-se o caso de um paciente com catarata bilateral e irregularidades corneanas e astigmatismo maior que 2 D à topografia, no qual implantou-se a LIO AcrySof® ReSTOR® no olho esquerdo associado à realização de incisões limbares relaxantes para tentar diminuir o astigmatismo corneano observado. A acuidade visual pós-operatória, tanto para perto quanto para longe, ficou abaixo das expectativas, sem melhora à refração e sem uma outra alteração que a justificasse, além das citadas. Após 45 dias, sem melhora da acuidade visual, efetuou-se o explante desta LIO, seguindo-se de implante de uma monofocal, sendo observada melhora da acuidade visual corrigida final. Assim, o presente caso clínico reforça a necessidade de uma correta seleção pré-operatória dos pacientes candidatos ao implante deste tipo de LIO multifocal, atentando inclusive para os dados topográficos.Currently, new types of intraocular lenses have been developed aiming to eliminate presbyopia and the use has become more popular. The authors report the case of a patient with bilateral cataract and corneal irregularities and astigmatism higher than 2D in the corneal topography, in which AcrySofTM ReSTOR TM intraocular lens was implanted in the left eye associated to relaxing limbal incisions trying to reduce corneal astigmatism. The near and distance postoperative visual acuity were worse than expected, with no improvement with refraction. Apparently, no other reason apart from irregular astigmatism/multifocal lens justified the low vision. After 45 days, with no visual acuity improvement, the intraocular lens was explanted and a monofocal one was implanted. The final corrected visual acuity improved. Thus, the present case emphasizes the need of a correct preoperative selection of patients to implant this type of

  18. Personalización de las constantes en las fórmulas de cálculo de la lente intraocular Personalization of constants in the intraocular lens calculation formulas

    Directory of Open Access Journals (Sweden)

    Anneé Miranda Carracedo

    2012-12-01

    Full Text Available Objetivo: personalizar las constantes A, factor cirujano y profundidad de la cámara anterior para las fórmulas de cálculo de la lente intraocular en la cirugía de catarata en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de mayo de 2007 a enero de 2011. Métodos: se realizó un estudio descriptivo retrospectivo donde se estudiaron las constantes A, factor cirujano y profundidad de la cámara anterior. También se evaluó la longitud axial preoperatoria por IOL Master, la mejor agudeza visual sin corrección, el componente esférico esperado, el componente esférico obtenido y los resultados refractivos. Resultados: las constantes optimizadas por interferometría de coherencia parcial son diferentes a las propuestas por los fabricantes de las lentes intraoculares. Estas constantes personalizadas para cada cirujano no mostraron diferencias significativas. Las constantes optimizadas según las longitudes axiales, tienen diferencias significativas en los 3 grupos de estudio. La diferencia entre la lente intraocular implantada y la propuesta con las nuevas constantes resultó menor de 1 D de error en 83,1 % de los pacientes. El 75,4 % quedó bien corregido en relación con la diferencia entre la refracción esperada y la obtenida. Conclusiones: las constantes optimizadas por interferometría de coherencia parcial resultan más elevadas que las propuestas por el fabricante. La optimización de estas en el cálculo de la lente permite, de acuerdo a las características individuales de cada ojo (longitud axial, usar la fórmula adecuada e incrementa la predictibilidad de los resultados refractivos posoperatorios.Objective: to personalize the A, surgeon factor and anterior chamber depth constants for intraocular lens calculation formulas in the cataract surgery at the “Ramón Pando Ferrer” Cuban Ophthalmological Institute from May 2007 to January 2011. Method: a retrospective and descriptive study was made to study the A constant

  19. Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry Efeito das lentes intraoculares asféricas e com pigmentação amarela na campimetria azul-amarelo

    Directory of Open Access Journals (Sweden)

    Rodrigo França de Espíndola

    2012-10-01

    Full Text Available PURPOSE: To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL on contrast sensitivity and blue-on-yellow perimetry. METHODS: This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes received ultraviolet and blue light filter (yellow tinted IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD] investigated two years after surgery. The results were compared intra-individually. RESULTS: There was a statistically significant between-group (aspherical and spherical intraocular lens difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. CONCLUSION: Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.OBJETIVO: Investigar a possibilidade de efeitos na sensibilidade ao contraste e nos resultados da campimetria azul-amarelo com implante de uma lente intraocular (LIO asférica ou de pigmentação amarela. MÉTODOS: Trata-se de um estudo prospectivo, randomizado, duplo-mascarado, envolvendo 52 pacientes portadores de catarata senil bilateral, divididos em dois grupos; 25

  20. Subluxação congênita do cristalino: resultados visuais e posição das lentes intraoculares após a cirurgia Congenital lens subluxation: visual acuity outcomes and intraocular lens postoperative position

    Directory of Open Access Journals (Sweden)

    Caroline Arraes

    2010-04-01

    Full Text Available OBJETIVO: Avaliar os resultados visuais e investigar, através da biomicroscopia ultrassônica, o posicionamento das lentes intraoculares e do anel endocapsular em 17 olhos de 10 portadores de subluxação congênita do cristalino, submetidos à mesma técnica cirúrgica pelo mesmo cirurgião. MÉTODOS: O estudo foi realizado no Hospital de Olhos de Pernambuco e Fundação Altino Ventura. A técnica cirúrgica consistiu em facoaspiração com implante de anel endocapsular e de lentes intraoculares com amputação de uma das alças. A idade variou entre 7 e 22 anos. Foram coletados dados sobre acuidade visual para longe pré e pós-operatória, tempo de seguimento após a cirurgia e complicações. Os pacientes foram submetidos à biomicroscopia ultrassônica. RESULTADOS: O tempo de seguimento médio foi de 2,8 anos. Houve melhora da acuidade visual para longe nos 17 (100% olhos: 12 olhos (70,6% apresentaram acuidade visual para longe melhor que 20/40; 4 (23,5% apresentaram acuidade visual para longe entre 20/40 e 20/100 e 1 (5,9% apresentou acuidade visual para longe pior que 20/100, porém melhor que acuidade visual para longe pré-operatória. A opacificação da cápsula posterior ocorreu em 10 olhos (58,9%. Na biomicroscopia ultrassônica observou-se que todas as lentes intraoculares estavam parcialmente descentralizadas, contudo sem atingir o bordo pupilar. Em todos os casos observou-se um adequado posicionamento do anel e um bom suporte capsular. CONCLUSÃO É possível concluir que o tratamento cirúrgico avaliado proporciona uma boa centralização das lentes intraoculares e do anel endocapsular, com melhora da acuidade visual para longe, sendo uma opção viável, eficaz e segura na reabilitação visual dos pacientes com subluxação congênita do cristalino.PURPOSE: To evaluate the visual acuity outcomes and to investigate the intraocular lens (IOL and endocapsular ring positions with ultrasound biomicroscopy in 17 eyes of 10 patients

  1. Efectividad de los lentes fáquicos Artisan en la corrección de la alta miopía Effectiveness of Artisan phakic lenses in the correction of high myopia

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    Yanele Ruiz Rodríguez

    2010-12-01

    Full Text Available OBJETIVO: Determinar la efectividad de los lentes intraoculares fáquicos Artisan en la corrección de la alta miopía en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de enero del 2006 a enero del 2009. MÉTODOS: Se realizó un estudio prospectivo, descriptivo. El universo estuvo constituido por el total de ojos (120 a los cuales se les implantó estos lentes. RESULTADOS: Se encontró un componente esférico de 0,5, no astigmatismo inducido y una mejoría de la agudeza visual corregida de 0,9. No se presentaron complicaciones transoperatorias y entre las posoperatorias mediatas predominó la iritis o uveítis (3,4 % así como la atrofia iridiana (5 % entre las tardías. CONCLUSIONES: Los resultados refractivos fueron favorables. Predominaron los pacientes sin complicaciones.OBJECTIVE: To determine the effectiveness of Artisan phakic intraocular lenses in correcting high myopia at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology in January 2006 to January 2009 period. METHODS: A prospective descriptive study was made in which the universe of study was 120 eyes implanted with this type of lenses. RESULTS: Spheral component of 0.5; the induced astigmatism was not found and the corrected visual acuity improvement was 0.9. There were no transoperative complications; the predominant postoperative mediate complications were iritis or uveitis (3.4 % and iridic atrophy (5 % prevailed in the late ones. CONCLUSIONS: The refractive results were favourable. The uncomplicated patients predominated.

  2. Comparative study on optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis ® ZMB00 and AcrySof ® IQ ReSTOR ® Multifocal IOL SN6AD1

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    Mario Augusto Pereira Dias Chaves

    2016-06-01

    Full Text Available ABSTRACT Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D, and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA, with analysis of contrast sensitivity (CS, wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868; postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68; DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000; and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001. In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05. Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04; however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003. The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for

  3. Chronic recurrent multifocal osteomyelitis: how to suggest this diagnosis?; L`osteite chronique recurrente multifocale. Un diagnostic qu`il faut savoir evoquer

    Energy Technology Data Exchange (ETDEWEB)

    Saint-Martin, Ch. [UCL Cliniques Saint-Luc, Bruxelles (Belgium); Kurelovic, I.; Soler, C.; Geoffray, A. [Fondation Laval, 06 - Nice (France); Durckel, J. [Hopital Hautepierre, 67 - Strasbourg (France)

    1997-09-01

    Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual. Spinal involvement is possible. Inconstant association with a cutaneous affection (palmo-plantar pustulosis, acne fulminans, psoriasis), or less frequently with an inflammatory chronic gut disorder is described. Pathogenesis usually recognized is an enthesopathy. Enthesitis may progress to the osseous part of the enthese and produce an aseptic chronic osteomyelitis. Biopsy specimen with culture is certainly necessary to rule out bacterial osteomyelitis and bone tumor. It is particularly true when the bone lesion is isolated. Disease course is benign and self-limited. The clinical course is characterized by recurrences and remissions occurring for 6 to 10 years. Treatment based on non steroid anti-inflammatory drugs is usually effective. (authors). 17 refs.

  4. Comparison of visual function and patient satisfaction with AcrySof ReSTORSN6AD1 multifocal intraocular compared to monofocal intraocular lenses 5

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    Aisa S Alchinova

    2016-12-01

    Full Text Available Aim. To compare visual function and satisfaction in patients after implantation of AcrySof ReSTOR SN6AD1 multifocal intraocular lens (IOL, AcrySof SA60AТ spherical monofocal IOL, or Akreos АО aspheric monofocal IOL during cataract surgery. Materials. Overall, 34 patients received SN6AD1 multifocal (group 1, 48 eyes, 19 patients received Akreos АО monofocal aspheric (group 2, 30 eyes, and 13 patients received AcrySof SA60AТ monofocal spherical (group 3, 18 eyes IOL. Patients with multifocal IOL were closely matched for age, sex, and ocular findings with patients who had monofocal IOL implantation. Six months postoperatively, uncorrected/corrected distance visual acuity (UDVA/CDVA, uncorrected intermediate (60 cm and near (35 cm visual acuity (UNVA, defocus curve, contrast sensitivity, and a quality-of-life questionnaire were evaluated. Furthermore, independence from glasses and presence of optical phenomena were assessed. Results. Patients in group 2 had statistically significant increase in UDVA than that in group 1 (p = 0.037. There was no significant difference in the mean uncorrected intermediate and best corrected distance visual acuities between the groups. UNVA was better in group 1 than that in groups 2 and 3 (p < 0.0001. Photopic contrast sensitivity for high spatial frequencies was better in groups 2 and 3. Glare was reported in 5.9% of patients in group 1. Halos occurred in 32.4% of patients in group 1. No one reported undesirable visual symptoms in groups 2 and 3. Conclusion. Multifocal IOLs provided higher spectacle independence and satisfactory functional vision over a broad range of distances but were associated with increased subjective visual symptoms and reduced photopic contrast sensitivity for high spatial frequencies and distance visual quality compared with monofocal IOLs.

  5. Comparing the relative peripheral refraction effect of single vision and multifocal contact lenses measured using an autorefractor and an aberrometer: A pilot study

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    Ravi C. Bakaraju

    2015-07-01

    Conclusion: For most test conditions, distinct differences were observed between the RPR measures obtained with the two modified instruments. The differences varied with CL design and centration. Although the pilot study supports the interchangeable use of the two instruments for on- and off-axis refraction in unaided eyes or eyes corrected with low/no spherical aberration; we advocate the use of the COAS-HD over the SN for special purposes like refracting through multifocal CLs.

  6. Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: the CAPEDP randomized controlled trial.

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    Romain Dugravier

    Full Text Available Postnatal maternal depression (PND is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed.This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties.440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child's second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS.At three months postpartum, mean (SD EPDS scores were 9.4 (5.4 for the control group and 8.6 (5.4 for the intervention group (p = 0.18. The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34. The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8: difference = 1.66 (95%CI: 0.17; 3.15, p = 0.05, adjusted for baseline EPDS score, women who were planning to raise the child with the child's father: difference = 1.45 (95%CI: 0.27; 2.62, p = 0.04 (adjusted; women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68 p = 0.05 (adjusted.CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction of PND symptomatology for young, first-time mothers presenting additional

  7. Extended depth of focus contact lenses vs. two commercial multifocals: Part 2. Visual performance after 1 week of lens wear.

    Science.gov (United States)

    Bakaraju, Ravi C; Tilia, Daniel; Sha, Jennifer; Diec, Jennie; Chung, Jiyoon; Kho, Danny; Delaney, Shona; Munro, Anna; Thomas, Varghese

    To compare the visual performance of prototype contact lenses designed via deliberate manipulation of higher-order spherical aberrations to extend-depth-of-focus with two commercial multifocals, after 1 week of lens wear. In a prospective, participant-masked, cross-over, randomized, 1-week dispensing clinical-trial, 43 presbyopes [age: 42-63 years] each wore AIROPTIX Aqua multifocal (AOMF), ACUVUE OASYS for presbyopia (AOP) and extended-depth-of-focus prototypes (EDOF) appropriate to their add requirements. Measurements comprised high-contrast-visual-acuity (HCVA) at 6m, 70cm, 50cm and 40cm; low-contrast-visual-acuity (LCVA) and contrast-sensitivity (CS) at 6m and stereopsis at 40cm. A self-administered questionnaire on a numeric-rating-scale (1-10) assessed subjective visual performance comprising clarity-of-vision and lack-of-ghosting at various distances during day/night-viewing conditions and overall-vision-satisfaction. EDOF was significantly better than AOMF and AOP for HCVA averaged across distances (p≤0.038); significantly worse than AOMF for LCVA (p=0.021) and significantly worse than AOMF for CS in medium and high add-groups (p=0.006). None of these differences were clinically significant (≤2 letters). EDOF was significantly better than AOMF and AOP for mean stereoacuity (36 and 13 seconds-of-arc, respectively: p≤0.05). For clarity-of-vision, EDOF was significantly better than AOP at all distances and AOMF at intermediate and near (p≤0.028). For lack-of-ghosting averaged across distances, EDOF was significantly better than AOP (p<0.001) but not AOMF (p=0.186). EDOF was significantly better than AOMF and AOP for overall-vision-satisfaction (p≤0.024). EDOF provides better intermediate and near vision performance than either AOMF or AOP with no difference for distance vision after 1 week of lens wear. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  8. PROGNOSTIC FACTORS OF POSITIVE RESULTS OF MULTIFOCAL TRUS-GUIDED VESICOURETHRAL ANASTOMOSIS BIOPSY IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

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    P. D. Demeshko

    2014-07-01

    Full Text Available Purpose. To evaluate influence of clinical, biochemical and histological factors to detection rate of local recurrence following radical prostatectomy (RPE using multifocal TRUS-guided vesicourethral anastomosis (VUA biopsy.Material and methods. 59 patients with newly diagnosed biochemical recurrence (BR after RPE were included into prospective study. All of them underwent multifocal TRUS-guided VUA biopsy. Сlinical variables (serum prostate-specifi c antigen [PSA] level and PSA kinetics, time RPE-BR, Gleason grade, stage after RPE and clinical findings were evaluated. Logistic regression and receiver operating characteristic (ROC curve analyses were performed.Results. The detection rate of local prostate recurrence with TRUS-guided VUA biopsy was 45,8 % (95 % CI 33,7–58,3. At multivariate analysis only PSA level at the moment of biopsy (≤ 1,5 ng/ml vs > 1,5 ng/ml and time RPE-BR (≤ 15 months vs > 15 months were significantly associated with positive results of multifocal TRUS-guided VUA biopsy (p < 0,05.Conclusion The detection rate of local prostate recurrence with TRUS-guided VUA biopsy depends on combination of independent predictors (PSA level at the moment of biopsy and time RPE—BR.

  9. Comparison of T stage, N stage, multifocality, and bilaterality in papillary thyroid carcinoma patients according to the presence of coexisting lymphocytic thyroiditis.

    Science.gov (United States)

    Park, Jin Young; Kim, Dong Wook; Park, Ha Kyung; Ha, Tae Kwun; Jung, Soo Jin; Kim, Do Hun; Bae, Sang Kyun

    2015-01-01

    This study aimed to assess the relationship between coexisting lymphocytic thyroiditis and T-N stages of papillary thyroid carcinoma (PTC) by histopathological analysis. The study included 653 patients who underwent thyroid surgery for PTC at our hospital. Each case was classified as either Hashimoto's thyroiditis (HT), non-Hashimoto type of lymphocytic thyroiditis (NHLT), or normal according to the histopathology of thyroid parenchyma. Patient age, gender, surgical modality, location, T stage, N stage, multifocality and bilaterality were compared according to the histopathology. The prevalence of coexisting lymphocytic thyroiditis was 25.8% (169/653); HT (7.5%, 49/653) and NHLT (18.3%, 120/653). There were no significant differences in T stage, N stage, multifocality and bilaterality with regard to coexisting lymphocytic thyroiditis, regardless of whether HT and NHLT were considered collectively or discretely. Primary tumor size (p thyroiditis did not differ from those with normal parenchyma in terms of T stage, N stage, multifocality and bilaterality.

  10. Ceratocone: correlação entre grau evolutivo e padrão topográfico com o tipo de lente de contato adaptada Keratoconus: correlation between degrees of severity and topographical pattern with the kind of fitted contact lens

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    Vinícius Coral Ghanem

    2003-01-01

    Full Text Available OBJETIVO: Verificar a existência de associações entre grau evolutivo e padrão topográfico do ceratocone com as lentes de contato (LC adaptadas. MÉTODOS: Estudo retrospectivo do tratamento de 454 pacientes (881 olhos com ceratocone, 746 adaptados com lentes de contato, de julho de 1996 a junho de 2000. Classificou-se o ceratocone segundo grau evolutivo e padrão topográfico. A primeira lente de contato testada foi rígida gás-permeável (RGP monocurva. Quando não se alcançou a adaptação desejada, testou-se as rígidas gás-permeáveis bicurvas e outros desenhos, procurando-se relação lente-córnea com livramento apical ou discreto toque apical. Em caso de insucesso com as rígidas foram testadas as lentes de contato gelatinosas, esféricas, tóricas e com desenhos especiais. RESULTADOS: Para 15 (3,3% pacientes foram receitados óculos; 111 olhos (12,6% permaneceram sem correção; 746 (84,68% olhos foram adaptados com LC; 39 olhos (4,44% de 39 pacientes (8,6% foram encaminhados para transplante de córnea. O grau evolutivo mais encontrado foi o avançado (575 olhos - 66,86%, seguido do incipiente (160 olhos - 18,6%. O valor ceratométrico médio do meridiano mais plano (K foi de 47,80 (±3,73 para os olhos adaptados com lentes de contato gelatinosas; de 49,03 (±3,7 para as lentes de contato rígidas gás-permeáveis monocurvas; de 51,62 (±3,6 para as lentes de contato bicurvas e de 51,14 (±3,5 para o sistema "piggyback". Quanto à classificação topográfica, o mais freqüente foi o periférico inferior (436 olhos - 50,7%, seguido pelo central assimétrico (348 olhos - 40,46%. No olho direito, a análise das variáveis padrão topográfico e tipo de lente adaptada demonstrou associação estatisticamente significante (p=0,045 de lentes de contato gelatinosas tóricas e sistema "piggyback" com percentual maior de adaptações nos ceratocones centrais. Com as lentes de contato rígidas gás-permeáveis monocurvas e bicurvas houve

  11. Human papillomavirus 13 in a Mexican Mayan community with multifocal epithelial hyperplasia: could saliva be involved in household transmission?

    Science.gov (United States)

    Lopez-Villanueva, Maria Eugenia; Conde-Ferráez, Laura; Ayora-Talavera, Guadalupe; Cerón-Espinosa, Jose D; González-Losa, Maria del Refugio

    2011-01-01

    Multifocal epithelial hyperplasia (MEH) is a disease of the oral mucosa. Human papillomaviruses 13 and 32 have been detected in these lesions. We describe the epidemiology and clinical characteristics of patients with MEH in a rural community in the Mayan area of Mexico with 53 cases and 54 controls. Clinical and epidemiological data were collected through a direct interview. Oral cell samples were collected with a cytobrush. Subjects collected their own saliva sample in a sterile bottle. All samples were tested for HPV 13 and 32 by polymerase chain reaction using specific primers. Of the 53 patients and 54 healthy subjects, 56% were < 12 years old, 25% were males and 75% females. Evolution of the lesions was between two months and 17 years. The lesions affected lips, jugal mucosa, and tongue, 96% had multiple lesions. From 53 patients, fifty samples of oral cells and 31 samples of saliva were analyzed. HPV 13 was detected in 100% oral cell and 100% saliva samples studied. 16 healthy subjects were HVP 13 positive. A highly significant association of HPV 13 infection and MEH was found, as determined by chi square test (p = 0.00) Household transmission of HPV 13 may happen through saliva and the shared use of contaminated objects.

  12. Implantation of a multifocal toric intraocular lens with a surface-embedded near segment after repeated LASIK treatments.

    Science.gov (United States)

    Khoramnia, Ramin; Auffarth, Gerd U; Rabsilber, Tanja M; Holzer, Mike P

    2012-11-01

    We report a 66-year-old patient who presented with increasing hyperopia, astigmatism, and presbyopia in both eyes 8 years after bilateral laser in situ keratomileusis (LASIK) and LASIK enhancement in the left eye aiming for spectacle independence. Bilateral multifocal toric Lentis Mplus intraocular lenses (IOLs) with an embedded near segment and individually customized cylinder correction were implanted uneventfully following phacoemulsification. The Haigis-L formula after previous hyperopia correction was chosen for IOL power calculation and provided reliable results. Emmetropia was targeted and achieved. Three months postoperatively, the uncorrected distance visual acuity had increased from 0.40 logMAR to 0.10 logMAR in the right eye and from 0.20 logMAR to 0.00 logMAR in the left eye. The patient gained 6 lines of uncorrected near visual acuity: 0.20 logMAR in the right eye and 0.10 logMAR in the left eye. This case shows that customized premium IOL implantation can provide accurate results even in challenging cases. The International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany, has received research grants, lecture fees, and travel reimbursement from Oculentis GmbH. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Modulation of the pupil function of microscope objective lens for multifocal multi-photon microscopy using a spatial light modulator

    Science.gov (United States)

    Matsumoto, Naoya; Okazaki, Shigetoshi; Takamoto, Hisayoshi; Inoue, Takashi; Terakawa, Susumu

    2014-02-01

    We propose a method for high precision modulation of the pupil function of a microscope objective lens to improve the performance of multifocal multi-photon microscopy (MMM). To modulate the pupil function, we adopt a spatial light modulator (SLM) and place it at the conjugate position of the objective lens. The SLM can generate an arbitrary number of spots to excite the multiple fluorescence spots (MFS) at the desired positions and intensities by applying an appropriate computer-generated hologram (CGH). This flexibility allows us to control the MFS according to the photobleaching level of a fluorescent protein and phototoxicity of a specimen. However, when a large number of excitation spots are generated, the intensity distribution of the MFS is significantly different from the one originally designed due to misalignment of the optical setup and characteristics of the SLM. As a result, the image of a specimen obtained using laser scanning for the MFS has block noise segments because the SLM could not generate a uniform MFS. To improve the intensity distribution of the MFS, we adaptively redesigned the CGH based on the observed MFS. We experimentally demonstrate an improvement in the uniformity of a 10 × 10 MFS grid using a dye solution. The simplicity of the proposed method will allow it to be applied for calibration of MMM before observing living tissue. After the MMM calibration, we performed laser scanning with two-photon excitation to observe a real specimen without detecting block noise segments.

  14. Detection of polyoma virus in brain tissue of patients with progressive multifocal leukoencephalopathy by real-time PCR and pyrosequencing.

    Science.gov (United States)

    Beck, Rose C; Kohn, Debra J; Tuohy, Marion J; Prayson, Richard A; Yen-Lieberman, Belinda; Procop, Gary W

    2004-03-01

    We evaluated 2 methods, a LightCycler PCR assay and pyrosequencing for the detection of the JC polyoma virus (JCV) in fixed brain tissue of 10 patients with and 3 control patients without progressive multifocal leukoencephalopathy (PML). Nucleic acid extraction was performed after deparaffinization and proteinase K digestion. The LightCycler assay differentiates the BK virus (BKV), JCV, and SV40 using melt curve analysis. Conventional PCR was used with the same primers to generate products for pyrosequencing. Two sequencing primers were used that differentiate the polyoma viruses. Seven of 11 biopsies (1 patient had 2 biopsies) with PML were positive for JCV by real-time PCR and/or PCR/pyrosequencing. Three of 4 remaining biopsies were positive by real-time PCR but had melting points between JCV and SV40. The 4 specimens that were negative or atypical by LightCycler PCR were positive by traditional PCR, but 1 had an amplicon of lower molecular weight by gel electrophoresis. These were shown to represent JCV by at least 1 of the 2 pyrosequencing primers. The biopsies from patients without PML were PCR negative. Both the LightCycler and pyrosequencing assays are useful for confirming JCV in brain biopsies from patients with PML, but variant JCVs may require supplementary methods to confirm JCV infection.

  15. Epiteliopatía pigmentaria placoide posterior multifocal aguda unilateral. A propósito de un caso

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    Ana Isabel Díaz Zapién

    2016-07-01

    Full Text Available Se presenta el caso de una mujer de 48 años de edad, que inicia su cuadro clínico con disminución súbita de agudeza visual acompañado de la presencia de un escotoma central en ojo derecho unilateral, sin otros síntomas acompañantes, antecedentes personales patológicos negados, 4 semanas después la paciente recupera visión llegando a un 20/20 sin la presencia del escotoma. La epiteliopatía pigmentaria placoide posterior multifocal aguda (EPPPMA es una patología inflamatoria coriorretiniana, que se presenta en adultos jóvenes, sanos, sin predominio por algún género, produciendo alteraciones visuales agudas, con hallazgos fundoscópicos característicos de lesiones placoides blanco-amarillentas a nivel del epitelio pigmentario de la retina. El diagnóstico se basa en los datos clínicos y la evolución complementado con la fluorangiografía, la mayoría de los casos con buen pronóstico visual, con una recuperación de la agudeza visual completa dentro de las primeras 3-6 semanas.

  16. Comparação da função visual e do índice de qualidade de vida com uso de óculos ou de lente de contato progressiva Comparative analysis of visual function and the quality of life index with eyeglasses or a progressive contact lens

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    Neusa Vidal Sant'Anna

    2006-06-01

    Full Text Available OBJETIVO: Comparar a função visual e a resposta dos pacientes ao índice de qualidade de vida quando estes são corrigidos com óculos com lentes progressivas ou lente de contato progressiva. MÉTODOS: Foram selecionados 35 pacientes présbitas, usuários de óculos com acuidade visual igual, ou melhor, a logMAR zero (longe e J1 (perto, para adaptarem a lente de contato Focus Progressive®. Foram comparadas medidas de acuidade visual para longe, perto e sensibilidade ao contraste com a lente de contato e com os óculos. Os resultados do questionário de avaliação de qualidade de vida NEI VFQ-25 dos mesmos pacientes corrigidos com os óculos e com a lente de contato progressiva foram comparados, levando-se em consideração o tipo de ametropia e a idade. RESULTADOS: A acuidade visual para longe, perto e a sensibilidade ao contraste foram significantemente piores com lente de contato progressiva do que com os óculos. As respostas do questionário não diferiram quanto à forma de correção quando se analisou o tipo de ametropia, entretanto foram significantemente piores com a lente de contato nos grupos míope e hipermétrope abaixo das suas respectivas medianas da idade e maiores no hipermétrope acima de sua mediana. CONCLUSÃO: As funções visuais foram significantemente piores com a lente de contato e o tipo de ametropia não influenciou nas respostas ao índice de qualidade de vida quanto à forma de correção, mas sim, quanto à idade.PURPOSE: To compare the visual function and the answers to a questionnaire of quality of life of patients wearing a progressive contact lens or eyeglasses. METHODS: The Focus Progressive® contact lens had been fitted in 35 patients with far visual acuity with progressive-addition eyeglasses equal to zero (log MAR and near J1 (Jaeger. The far and near visual acuities and the measurement of contrast sensitivity were compared when the patients were wearing the eyeglasses or the contact lens and the

  17. Clinical Evaluation of Functional Vision of +1.5 Diopters near Addition, Aspheric, Rotational Asymmetric Multifocal Intraocular Lens.

    Science.gov (United States)

    Kretz, Florian Tobias Alwin; Khoramnia, Rahmin; Attia, Mary Safwat; Koss, Michael Janusz; Linz, Katharina; Auffarth, Gerd Uwe

    2016-10-01

    To evaluate postoperative outcomes and visual performance in intermediate distance after implantation of a +1.5 diopters (D) addition, aspheric, rotational asymmetric multifocal intraocular lens (MIOL). Patients underwent bilateral cataract surgery with implantation of an aspheric, asymmetric MIOL with +1.5 D near addition. A complete ophthalmological examination was performed preoperatively and 3 months postoperatively. The main outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA) and distance corrected keratometry, and manifest refraction. The Salzburg Reading Desk was used to analyze unilateral and bilateral functional vision with uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at near and intermediate distances. The study comprised 60 eyes of 30 patients (mean age, 68.30 ± 9.26 years; range, 34 to 80 years). There was significant improvement in UDVA and CDVA. Mean UIVA was 0.01 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and mean DCIVA was -0.02 ± 0.11 logMAR. In Salzburg Reading Desk analysis for UIVA, the mean subjective intermediate distance was 67.58 ± 8.59 cm with mean UIVA of -0.02 ± 0.09 logMAR and mean word count of 96.38 ± 28.32 words/min. The new aspheric, asymmetric, +1.5 D near addition MIOL offers good results for distance visual function in combination with good performance for intermediate distances and functional results for near distance.

  18. Clinical and optical intraocular performance of rotationally asymmetric multifocal IOL plate-haptic design versus C-loop haptic design.

    Science.gov (United States)

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Vega-Estrada, Alfredo

    2013-04-01

    To compare the visual and intraocular optical quality outcomes with different designs of the refractive rotationally asymmetric multifocal intraocular lens (MFIOL) (Lentis Mplus; Oculentis GmbH, Berlin, Germany) with or without capsular tension ring (CTR) implantation. One hundred thirty-five consecutive eyes of 78 patients with cataract (ages 36 to 82 years) were divided into three groups: 43 eyes implanted with the C-Loop haptic design without CTR (C-Loop haptic only group); 47 eyes implanted with the C-Loop haptic design with CTR (C-Loop haptic with CTR group); and 45 eyes implanted with the plate-haptic design (plate-haptic group). Visual acuity, contrast sensitivity, defocus curve, and ocular and intraocular optical quality were evaluated at 3 months postoperatively. Significant differences in the postoperative sphere were found (P = .01), with a more myopic postoperative refraction for the C-Loop haptic only group. No significant differences were detected in photopic and scotopic contrast sensitivity among groups (P ⩾ .05). Significantly better visual acuities were present in the C-Loop haptic with CTR group for the defocus levels of -2.0, -1.5, -1.0, and -0.50 D (P ⩽.03). Statistically significant differences among groups were found in total intraocular root mean square (RMS), high-order intraocular RMS, and intraocular coma-like RMS aberrations (P ⩽.04), with lower values from the plate-haptic group. The plate-haptic design and the C-Loop haptic design with CTR implantation both allow good visual rehabilitation. However, better refractive predictability and intraocular optical quality was obtained with the plate-haptic design without CTR implantation. The plate-haptic design seems to be a better design to support rotational asymmetric MFIOL optics. Copyright 2013, SLACK Incorporated.

  19. First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

    International Nuclear Information System (INIS)

    Oexle, C.; Reinhardt, M.; Moser, E.

    1998-01-01

    Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99m Tc-pertechnetate thyroid uptake under suppression (TcTU s ) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTU s , which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTU s of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTU s >3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.) [de

  20. Assessment of multifocal contact lens over-refraction using an infrared, open-field autorefractor: A preliminary study.

    Science.gov (United States)

    Giner, Anna; Aldaba, Mikel; Arjona, Montserrat; Vilaseca, Meritxell; Pujol, Jaume

    2015-10-01

    To evaluate the usefulness of an infrared open-field autorefractor as a predictor of the refractive error when fitting multifocal contact lenses (MCL). Objective and subjective measurements of the non-cycloplegic distance refractive error were compared in patients wearing MCL. We used the Grand Seiko WAM-5500 autorefractor for the objective measurements. Three commercially available MCL were tested. Twenty-one eyes of sixteen healthy adults were included in the study. Over-refraction was evaluated in terms of spherical equivalent (SE) and astigmatic vectors (J0 and J45). The mean difference±SD of each parameter was calculated. The Kolmogorov-Smirnov test was used to verify the normal distribution. Pearson's correlation, Bland and Altman plot and paired sample t test were used to compare the results obtained with both methods. The mean difference between objective and subjective results of the SE over-refraction was 0.13±0.42D; for astigmatic vectors J0 and J45 were 0.03±0.32D and -0.00±0.17D, respectively. The Kolmogorov-Smirnov test showed a normal distribution for all parameters. The highest Pearson's correlation coefficients were obtained for the SE with values of 0.98 without MCL and 0.97 with MCL. The lowest were obtained for J45 with values of 0.65 without MCL and 0.75 with MCL. Significant correlations were obtained for each parameter. The paired sample t test failed to show significant differences in analyzed parameters except for J0 without MCL. The Grand Seiko WAM-5500 can be used as a screening method of over-refraction in the clinical fitting of MCL. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  1. Neurovirulence of H5N1 infection in ferrets is mediated by multifocal replication in distinct permissive neuronal cell regions.

    Directory of Open Access Journals (Sweden)

    Jennifer R Plourde

    Full Text Available Highly pathogenic avian influenza A (HPAI, subtype H5N1, remains an emergent threat to the human population. While respiratory disease is a hallmark of influenza infection, H5N1 has a high incidence of neurological sequelae in many animal species and sporadically in humans. We elucidate the temporal/spatial infection of H5N1 in the brain of ferrets following a low dose, intranasal infection of two HPAI strains of varying neurovirulence and lethality. A/Vietnam/1203/2004 (VN1203 induced mortality in 100% of infected ferrets while A/Hong Kong/483/1997 (HK483 induced lethality in only 20% of ferrets, with death occurring significantly later following infection. Neurological signs were prominent in VN1203 infection, but not HK483, with seizures observed three days post challenge and torticollis or paresis at later time points. VN1203 and HK483 replication kinetics were similar in primary differentiated ferret nasal turbinate cells, and similar viral titers were measured in the nasal turbinates of infected ferrets. Pulmonary viral titers were not different between strains and pathological findings in the lungs were similar in severity. VN1203 replicated to high titers in the olfactory bulb, cerebral cortex, and brain stem; whereas HK483 was not recovered in these tissues. VN1203 was identified adjacent to and within the olfactory nerve tract, and multifocal infection was observed throughout the frontal cortex and cerebrum. VN1203 was also detected throughout the cerebellum, specifically in Purkinje cells and regions that coordinate voluntary movements. These findings suggest the increased lethality of VN1203 in ferrets is due to increased replication in brain regions important in higher order function and explains the neurological signs observed during H5N1 neurovirulence.

  2. Trichostrongylina (Nematoda, Heligmosomoidea coparasites in Dasyprocta fuliginosa Wagler (Rodentia, Dasyproctidae from Brazil, with the re-establishment of the genus Avellaria Freitas & Lent and the description of two new species Trichostrongylina (Nematoda, Heligmosomoidea co-parasitos em Dasyprocta fuliginosa Wagler (Rodentia, Dasyproctidae do Brasil, com o restabelecimento do gênero Avellaria Freitas & Lent e a descrição de duas novas espécies

    Directory of Open Access Journals (Sweden)

    Marie C. Durette-Desset

    2006-06-01

    Full Text Available Two new tichostrongylid nematodes of the family Viannaiidae Durette-Desset & Chabaud, 1981 coparasites in Dasyprocta fuliginosa Wagler, 1832 from the State of Amazonas, Brazil, are described: Viannella trichospicula sp. nov. is differentiated from the other species of the genus by the extreme slenderness of its spicules. Avellaria intermedia sp. nov. is distinguished from the single type species Avellaria avellari Freitas & Lent, 1934, by a smaller number of cuticular ridges (17 versus 27, a higher ratio of spicule length/ body length (8% versus 5.6% and spicules with a single tip. This genus, synonymized with the genus Viannella Travassos, 1918, by Durette-Desset (1968 is re-established, the female being didelphic. It is the first record of a nematode of the family Viannaiidae in a host of the family Dasyproctidae Bonaparte, 1838.Dois novos nematóides tricostrongilídeos da família Viannaiidae Durette-Desset & Chabaud, 1981 co-parasitos em um espécime de Dasyprocta fuliginosa Wagler, 1832 do Estado do Amazonas, Brasil, são descritos: Viannella trichospicula sp. nov. distingue-se das espécies do gênero, pelos espículos extremamente delgados. Avellaria intermedia sp. nov. diferencia-se da espécie tipo e única do gênero Avellaria avellari Freitas & Lent, 1934, pelo menor número de arestas cuticulares (17 comparado a 27, pela maior relação entre o tamanho do espículo e o comprimento do corpo (8% comparado a 5,6% e espículos com extremidade única. Este gênero, que havia sido considerado sinônimo de Viannella Travassos, 1918, por Durette-Desset (1968, é restabelecido; as fêmeas são didelfas. Este é o primeiro registro de um nematóide da família Viannaiidae em um hospedeiro da família Dasyproctidae Bonaparte, 1838.

  3. Extended depth of focus contact lenses vs. two commercial multifocals: Part 1. Optical performance evaluation via computed through-focus retinal image quality metrics.

    Science.gov (United States)

    Bakaraju, Ravi C; Ehrmann, Klaus; Ho, Arthur

    To compare the computed optical performance of prototype lenses designed using deliberate manipulation of higher-order spherical aberrations to extend depth-of-focus (EDOF) with two commercial multifocals. Emmetropic, presbyopic, schematic eyes were coupled with prototype EDOF and commercial multifocal lenses (Acuvue Oasys for presbyopia, AOP, Johnson & Johnson & Air Optix Aqua multifocal, AOMF, Alcon). For each test configuration, the through-focus retinal image quality (TFRIQ) values were computed over 21 vergences, ranging from -0.50 to 2.00D, in 0.125D steps. Analysis was performed considering eyes with three different inherent aberration profiles: five different pupils and five different lens decentration levels. Except the LOW design, the AOP lenses offered 'bifocal' like TFRIQ performance. Lens performance was relatively independent to pupil and aberrations but not centration. Contrastingly, AOMF demonstrated distance centric performance, most dominant in LOW followed by MED and HIGH designs. AOMF lenses were the most sensitive to pupil, aberrations and centration. The prototypes demonstrated a 'lift-off' in the TFRIQ performance, particularly at intermediate and near, without trading performance at distance. When compared with AOP and AOMF, EDOF lenses demonstrated reduced sensitivity to pupil, aberrations and centration. With the through focus retinal image quality as the gauge of optical performance, we demonstrated that the prototype EDOF designs were less susceptible to variations in pupil, inherent ocular aberrations and decentration, compared to the commercial designs. To ascertain whether these incremental improvements translate to a clinically palpable outcome requires investigation through human trials. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  4. Does the apodized diffractive intraocular lens Acrysof ReSTOR NaturalTM interfere with FDT Matrix perimetry results? A lente difrativa apodizada Acrysof ReSTOR NaturalTM pode interferir nos resultados da perimetria por FDT Matrix?

    Directory of Open Access Journals (Sweden)

    Karine Duarte Bojikian

    2009-12-01

    Full Text Available PURPOSE: To compare the effect of an apodized diffractive intraocular lens (IOL (Acrysof ReSTOR NaturalTM and its yellow counterpart (Natural IQ TM on frequency doubling technology (FDT perimetry results. METHODS: This study included 37 eyes from 22 patients at the "Centro Oftalmológico Tranjan" who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR NaturalTM, 20 Natural IQ TM performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. RESULTS: The patients were between 41 to 79 years old (mean, 70.78 ± 9.83 in the Natural IQ TM and 49 to 81 years old (mean, 67.11± 11.48 in the Acrysof ReSTOR NaturalTM group, and the mean IOP was 13.64 ± 2.02 mmHg in the Natural IQ TM 12.94 ± 1.39 mmHg in the Acrysof ReSTOR NaturalTM group. The mean pupillary diameter under scotopic conditions was 6.63 ± 1.16 mm in the Natural IQ TM group and 7.20 ± 1.8 mm in the Acrysof ReSTOR NaturalTM group (p=0.20. The mean deviation was -1.83 ± 3.46 dB in the Natural IQ TM group and -1.77 ± 3.94 dB in the Acrysof ReSTOR NaturalTM group (p=0.28. The pattern standard deviation was 3.49 ± 0.79 dB in the Natural IQ TM group and 3.20 ± 0.86 dB in the Acrysof ReSTOR NaturalTM group (p=0.27. CONCLUSION: There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant.OBJETIVO: Comparar o efeito da lente difrativa apodizada (Acrysof ReSTOR NaturalTM e da lente de mesma plataforma amarela (Natural IQ TM sobre os resultados da perimetria de dupla frequência (FDT. MÉTODOS: O estudo incluiu 37 olhos de 22 pacientes do Centro Oftalmológico Tranjan que foram submetidos a cirurgia de facoemulsificação e implante de lentes intraoculares (17 Acrysof ReSTOR NaturalTM, 20 Natural IQ TM sem complicações, realizadas pelo mesmo

  5. ANALYSIS OF THE RESULTS OF PRESBYOPIA CORRECTION WITH APPLICATION OF A BI-ASPHERIC MULTIFOCAL PROFILE ON THE CORNEA BY THE PRK FOR PATIENTS WITH MYOPIA AND HYPEROPIA

    Directory of Open Access Journals (Sweden)

    E. N. Eskina

    2017-01-01

    Full Text Available Purpose. To compare the efficacy, safety and predictability of presbyopia correction by the PRK with application of a bi-aspheric multifocal profile on the cornea with PresbyMax software for patients with hyperopia and myopia.Patients and methods: There were 2 patients group of 25 people each (50 eyes. They were operated with PRK method with application of a multifocal biaspheric profile for simultaneous correction of ametropia and presbyopia. Group I — patients with myopia and presbyopia. Group II — patients with hypermetropia and presbyopia.Results. In the group 1 year post operation binocular DUCVA was 0,93±0,19, NUCVA — 0,86±0,14, IUCVA — 0,67±0,11. Only two eyes (4 % lost DBCVA on the 1–2 lines. Target refraction of a dominant eye — emmetropia was 72 % of patients, 28 % observed myopia of –0,75 D. Target refraction of a nondominant eye was –0,75, 68 % had this result, 28 % had deviation –0,50 D of the target refraction, and 4 % — 1,00 D. In group 2 a year post operation binocular DUCVA was 0,96±0,16, NUCVA — 0,77±0,19, IUCVA — 0,64±0,15. Only two eyes (4 % lost DBCVA on the 1–2 lines. Target refraction of a dominant eye — emmetropia was 72 % of patients, 28 % observed myopia of –0,75 D. Target refraction of a nondominant eye was –0,75, 68 % had this result, 32 % had deviation to –0,75 D of the target refraction.Conclusions. PRK with application of a bi-aspheric multifocal profile on the cornea using PresbyMAX software and µ-monovision is effective for correction myopia and hypermetropia. Simultaneous correction of ametropia and presbyopia by the PRK method with the application of the multifocal biospheric profile to the cornea with the formation of a slight anisometropia (the concept of µ-monovision with the PresbyMax software is an effective, safe and predictable method of surgical intervention, both in myopia and hypermetropia.

  6. [Hyperopic Laser-in-situ-Keratomileusis after trifocal intraocular lens implantation : Aberration-free femto-Laser-in-situ-Keratomileusis treatment after implantation of a diffractive, multifocal, toric intraocular lens-case analysis].

    Science.gov (United States)

    Hemkeppler, E; Böhm, M; Kohnen, T

    2018-05-29

    A 52-year-old highly myopic female patient was implanted with a multifocal, diffractive, toric intraocular lens because of the wish to be independent of eyeglasses. Despite high-quality, extensive preoperative examinations, a hyperopic refractive error remained postoperatively, which led to the patient's dissatisfaction. This error was treated with Laser-in-situ-Keratomileusis (LASIK). After corneal LASIK treatment and implantation of a diffractive toric multifocal intraocular lens the patient showed a good postoperative visual result without optical phenomena.

  7. Diagnostic value of combined magnetic resonance imaging examination of brachial plexus and electrophysiological studies in multifocal motor neuropathy

    Directory of Open Access Journals (Sweden)

    Basta Ivana

    2014-01-01

    Full Text Available Background/Aim. Multifocal motor neuropathy (MMN is an immune-mediated disorder characterized by slowly progressive asymetrical weakness of limbs without sensory loss. The objective of this study was to investigate the involvement of brachial plexus using combined cervical magnetic stimulation and magnetic resonance imaging (MRI of plexus brachialis in patients with MMN. We payed special attention to the nerve roots forming nerves inervating weak muscles, but without detectable conduction block (CB using conventional nerve conduction studie