Biomedical subjects
Publications and source records attributed to J Royer.
SSPE is a panencephalitis who involves children and who leads to death. It is due to a defective measles virus. Ophthalmologic features are frequent and may be the first manifestation of the disease. The most typical ocular involvement is retinitis which can be misdiagnosed as a toxoplasmosis.
The purpose of our study was to evaluate the individual variations of the foramen sometimes has the same dimensions as the foramen of the other cervical vertebrae, but it can also be smaller, or absent. In cases where the foramen is present in the seventh cervical vertebra, vascular or nerve structures (or both) can be occasionally observed within. When the transverse foramina are found to contain none of the above structures, what then is to be found within this space? According to our results, the transverse foramina of the seventh cervical vertebra almost universally contain vascular and nerve branches as well as fibrous and adipose tissue. This report concerns the results of the macroscopic and microscopic studies concerning the contents of the transverse foramina of the seventh cervical vertebra.
This study used peripheral human corneal epithelium in tissue culture. Cells were observed in cytology, histology and by immunofluorescence staining. This in vitro-system may provide a suitable model to study biocompatibility but also to collect free human corneal cells.
A study of 36 penetrating keratoplasties using donor corneas stored at +37 degrees C in organ culture incubation for an average of 12 days prior to transplantation is reported. The criteria for the survival of corneal grafts were mean central corneal thickness, clarity of the cornea and mean endothelial cell density. A total of 86% of the grafts remained clear after 12 months follow-up time. The mean central corneal thickness was 0.47 mm. The mean endothelial cell density was 1452 cells/mm2. Based on the results of this study, organ culture reported here appears to be a safe and efficient method of medium to long-term corneal storage.
Choroid osteoma was described for the first time by GASS in 1978. Today only 53 cases were reported in 39 patients. Using 3 new cases recently discovered in our region, we try to assess with the help of the already published data, the main points of the disease and its diagnostic.
The term "pre-equatorial syndrome" covers post-traumatic involvement of the anterior segment and of the pre-equatorial retina, due to a frontal distension mechanism. In a retrospective study, we studied 582 cases of ocular contusions from 1973 to 1986 in patients who required a brief hospitalisation in our clinic because of the severity of the initial injury. The aim of the study was to assess the occurrence of this syndrome, its clinical features and evolution. 59 complete pre-equatorial syndromes were found in this sample (10.2% of all the ocular contusions). The follow up ranged from one to 168 months. Games and sports injuries in children and work injuries in young men were most commonly found causes (2/3 of the cases). Hyphema and angle recession were the most frequently observed lesions (69%). All hyphemas disappeared spontaneously without surgical drainage. Subluxation of the lens was present in 10.6% and late post traumatic cataract occurred in four cases; all eyes were operated on by intracapsular extraction, three of them in the first year following the traumatism and the last twelve years latter. Intraocular pressure was high in 15.3% (but was easily controlled) and was very low in 5.1%. Retinal edema and haemorrhages were the most common involvement of the peripheral retina. Retinal dialysis was noticed in 13.6% especially in the upper nasal area: buckling surgery was performed in these cases with good results. Anterior and peripheral retinal damages was situated on the same meridian in 80% of the cases, five eyes showed a 180 degrees opposite setting while there was no obvious alignment in 15 of the cases. This syndrome did not impair final visual function alone, whereas severe associated ocular contusions of the posterior pole gave a very low visual outcome in 16 cases. This retrospective review emphasizes the main characteristics of this syndrome. Accurate examination of the irido-corneal angle and peripheral retina is of paramount importance in every ocular contusion.
Authors have studied the penetration of ciprofloxacin in the aqueous humor of 30 patients (30 eyes). The concentration in the anterior chamber was on average 0.73 mg/l (33% of serum level), from 1.30 hours after a single oral dose (1000 mg) till the 5th hour after this dose. The samples were assessed by a microbiological method. These results are over the minimal inhibitory concentration for many bacterial agents found in endophthalmitis. So this antibiotic may be proposed in the treatment of endophthalmitis, with further investigations assessing the safety of this procedure.
This study uses extensometry to compare the distribution of strain on a fresh femur before and after implantation of various titanium prostheses: one is a cementless implant with metaphyseal endosteal support; the second is a cemented prosthesis with and without calcar collar contact; the last is a titanium implant with fixation by screens. The precision of the measurements have been improved particularly in the proximal metaphyseal area using bidirectional gauges. The system of loading permits comparison of the different implants and the results obtained with the B.P.R. prosthesis compared with the cemented implant without calcar contact are very close. The effect of the collar appears very limited despite the optimal conditions of the in vivo implantation that improve the calcar-collar contact. The screw implant increases the stress shielding of the proximal area of the femur. The different steps of the experiment illustrate the strain distribution in relation to the implantation of the devices and the contact bone prosthesis. The significant endosteal fixation of the B.P.R. prosthesis in the proximal metaphyseal area allows a better primary anchorage which increases distribution of the stress and therefore results in better secondary fixation by bony ingrowth.
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Automated perimetry was performed on 32 eyes of 31 patients with posterior chamber intraocular lens. Visual field and retinal sensibility were studied a week and three months after surgery for each eye. Decreased retinal sensibility in the foveal area was observed in 75% of the eyes. Such a deficiency was also noted in the nasal visual field from 30 to 45 degrees, and within 60 degrees in the temporal area. Further investigation is mandatory to assess our hypothesis about this phenomenon.
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The Opacity Lensmeter is a new instrument permitting the measurement of lens opacity. This preliminary report was performed on 98 patients (195 phakic eyes). Age, sex, lens opacity and retinal sensibility (using automated perimetry with the Octopus 2000 R) were assessed. A correlation between age and lens opacity was found in a simple linear regression model on 186 eyes (available data): opacity = 0.00423 square (age) + 5.18. An another more precise correlation was found in 138 eyes, excluding those with anterior segment abnormalities and corneal opacity: opacity = 0.0035 square (age) + 5.17. No statistical differences were observed between lens opacity and sex nor were left/right differences significant. No conclusion was possible concerning retinal sensibility and measured lens opacity because of the small sample (25 eyes). This easily handled instrument may be helpful in daily practice to evaluate opacity in lens pathology. Furthermore, it should be useful for the interpretation of the respective role of cataract and retinal damage in P.O.A.G. loss of retinal sensibility.
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Forty patients more than 65 years old were anaesthetized with propofol for cataract surgery. Patients were divided into two groups: those intubated after topical oropharyngeal anaesthesia and those intubated after muscle relaxation obtained with suxamethonium. Induction and maintenance of anaesthesia were carried out with 2.5 mg . kg-1 and 4 mg . kg-1 . h-1 respectively. Concurrent use of muscle relaxants had no effect on the action and characteristics of the general anaesthesia or recovery. Relative bradycardia (7%) and arterial hypotension (25%) occurred rapidly following induction and continued during the entire period of anaesthesia despite the systematic infusion of 500 ml of electrolyte solutions. Recovery was extremely rapid. The original Glasgow score was obtained within 20 min. The only negative side-effects were generally late occurring (4-6 h): postanaesthetic nausea or vomiting. Otherwise, tolerance was excellent. Use of propofol was ideal for this type of surgery due to its strong and durable ocular hypotensive effect.
The Octopus global analysis Program G1 was developed as a glaucoma program. It is the combination in a single program of: examination procedures, visual field assessment methods. The whole examination is carried out in three phases: the first phase measures 59 test locations in the central 30 degrees field. All locations are measured with the normal strategy. The local threshold is precisely determined to +/- 1 dB by the proven bracketing method. At the end of the first phase, the system automatically calculates the key values (visual field indices) for mean defect and loss variance. the second phase, which retests the same central field, starts from the threshold values measured during phase one. The additional indices corrected loss variance and short term fluctuation, are calculated. in the last phase 14 selected peripheral points between 30 and 60 degrees excentricity with particular emphasis on the superior and inferior nasal step are determined in a qualitative test. Visual field changes can be detected and categorized in three major groups: (Flammer and coll., 1985). 1. local defects or scotomas in varying depths and sizes. 2. diffused depression of the whole field. 3. Increased short-term. The original index called Corrected Loss Variance could determine an early defect before the existence of a light scotoma. Particularly, an increased Corrected Loss Variance indicates that the deviations are due to real scotomas and not just to scattering effects. The therapeutic decision could be more rational.
Authors use the Octopus 2000 automatic perimeter to study the evolution of visual field defects of 37 glaucomatous eyes treated by argon laser trabeculoplasty and followed up for one year. In a first time, half inferior laser trabeculoplasty is performed; half superior complement is done three months later if visual field defects improve. Various visual fields are compared by statistic delta program. Three months after trabeculoplasty more than 85% of visual field loss decrease or are stabilized. The same results are found after one year, without modification of initial medication.
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The authors have studied the penetration of Ofloxacin in the aqueous humour in 30 patients (30 eyes). Six hours after a single oral dose of 200 mg, the concentration in the anterior chamber reached 0.6 microgram/ml which is 23% of the average serum level. It is over the minimal inhibitory concentration necessary for many bacterial agents found in endophthalmitis (except Streptococcus) because the MIC of Ofloxacin are the lowest among quinolones. Side effects and association with other antibiotics are precise.