PURPOSE: To evaluate the effect of pars plana filtration with multiple laser perforation of the uvea in neovascular glaucoma patients following proliferative diabetic retinopathy. METHODS: In 18 eyes of 13 patients, after a fornix-based conjunctival incision, two 9 x 3 mm, thin, rectangular scleral flaps were created 3-6 mm posterior to the limbus. The remaining layers of sclera under each flap were removed. The exposed uvea was irradiated at a mean of 60.6 spots with an argon laser just to the point of perforation. After the posterior chamber fluid escaped, the flaps were sutured. RESULTS: The mean preoperative intraocular pressure (IOP) was 36.4 +/- 9.0 mm Hg. After an average follow-up of 16.6 +/- 5.9 months, the mean final postoperative IOP was 16.6 +/- 4.4 mm Hg. The postoperative IOP was below 21 mm Hg in 3 (16.7%) of the 18 eyes without medication, in 14 (77.8%) on anti-glaucoma eye drops, and in 16 (88. 9%) on anti-glaucoma eye drops and an oral carbonic anhydrase inhibitor. Snellen visual acuity improved by more than 2 lines in 7 of the 18 eyes, worsened by this amount in 3, and remained within baseline +/- 2 lines in 8. CONCLUSION: This procedure is an effective treatment for neovascular glaucoma patients following proliferative diabetic retinopathy.

Acetazolamide↗

PubMedDate not supplied

Effectiveness of transaortic venting from a failing left ventricle during venoarterial bypass.

Insufficient unloading of the left ventricle (LV) is a limitation of percutaneous cardiopulumonary support (PCPS). We previously reported the unloading effect of transaortic catheter venting (TACV) during venoarterial bypass (VAB) in normal hearts. The aim of this study was to assess the effectiveness of TACV with VAB in a heart failure (HF) model. Seven adult mongrel dogs underwent TACV with VAB, and isolated LV failure was induced by multiple ligation of left coronary arteries. With standard hemodynamic monitoring, slope of the LV end-systolic pressure-volume relationship (Emax; mm Hg/ml), aortic elastance (Ea; mm Hg/ml), LV stroke work (SW; 10(-4)J), preload recruitable stroke work (PRSW; 10(-4)J/ ml), LV pressure-volume area (PVA; 10(-4)J), and potential energy (PE; 10(-4)J) were assessed using a micro-tip manometer and a conductance catheter. In addition to evaluation of LV function, myocardial adenosine 5'-triphosphate (ATP) was measured in each condition. The TACV combined support significantly reduced LV total energy (PVA) and LV work (SW). The LV energetic charge (PE/PVA, myocardial ATP) was significantly increased by TACV. These results suggest that TACV might be an effective technique for LV recovery during VAB or PCPS in patients with severe heart failure.

Animals↗

PubMedDate not supplied

Norepinephrine turnover in the cardiovascular tissues and brain stem of the rabbit during development of one-kidney and two-kidney Goldblatt hypertension.

To assess the role of the sympathetic and central noradrenergic neurons in one- and two- kidney Goldblatt hypertension, we examined the concentration and turnover of norepinephrine (NE) in the aorta, mesenteric artery, left ventricle, hypothalamus, midbrain, and pons medulla of hypertensive and control rabbits. Animals were made hypertensive by constriction of the left renal artery after right nephrectomy (1KGH group) or with the right kidney left intact (2KGH group), or were sham-operated on the renal artery (1KGC and 2KGC groups). At 14 days after the constriction, the blood pressure was increased to 136 +/- 3 mm Hg in the 1KGH vs 98 +/- 3 mm Hg in the 1KGC (p less than 0.001), and 136 +/- 2 mm Hg in the 2KGH vs 94 +/- 2 mm Hg in the 2KGC group (p less than 0.001). Turnover time in the aorta, mesenteric artery, and left ventricle in the 1KGH group was decreased to 47%, 45%, and 65% of that in the 1KGC group, respectively. Results suggest that enhanced sympathetic neuron activity in the cardiovascular system, especially in the arteries, contributes to the development of one-kidney Goldblatt hypertension. Norepinephrine turnover in the cardiovascular tissues in the 2KGH group and in the brain stem in the 1KGH and 2KGH group was not different from that in the control group.

Animals↗