[Intravitreous gas injections in microsurgery for retinal detachment].
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Biomedical subjects
Publications and source records attributed to M Bonnet.
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The late or intercurrent facilitation of the soleus H reflex recovery cycle was studied during the preparatory period of a visual reaction time task. Response preparation produced three kinds of effect on the conditioned reflex elicited 200 msec before the end of the preparatory period: depression of the conditioned reflex which was maximum at the 150 msec conditioning interval; enhancement of the conditioned reflex which was maximum at the 300 msec conditioning interval; and, when the soleus muscle was involved in the execution of the voluntary response, an additional depression of the conditioned reflex at each conditioning interval. These different effects of response preparation are discussed with reference to the neural mechanisms which are thought to mediate the intercurrent facilitation.
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A randomized double-blind trial was conducted in 143 out-patients with allergic conjunctivitis (281 eyes). Active sodium cromoglycate collyre was compared with placebo in parallel groups over a four-week period. Highly significant advantage for active drug was demonstrated for subjective and objective symptoms as well as for overall assessment by patients and physicians. Results were compared with international data concerning this well-known anti-allergic compound.
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Four cases of acute panendothelial retinal leakage in juvenile diabetes are presented. One patient showed acute disc swelling mimicking optic disc new vessels, one had acute cystoid maculopathy, two had both diffuse retinal leakage and optic disc edema. Acute disc swelling and acute cystoid maculopathy in juvenile diabetes are probably variations of the same clinical entity. Acute endothelial leakage can involve either the epipapillary and peripapillary radial capillaries (acute disc swelling), the retinal capillaries of the posterior pole (acute cystoid maculopathy), or the entire epipapillary and retinal capillary network (diffuse panendothelial retinal leakage). Photocoagulation treatment is not indicated in the management of this specific clinical entity. In fact, acute panendothelial retinal leakage in juvenile diabetes seems to be related to poor blood sugar control. In 3 cases the"spontaneous" favorable course of the disease was probably related to the modification of insulin dosage after discovery of the ocular disease.
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Acetylcholinesterase (AChE) in amniotic fluid from 165 normal pregnancies and 38 abnormal pregnancies was measured, using a direct assay of AChE activity after inhibition of ChnS with ethopropozine ("Lysivane"). Samples from normal pregnancies of 16-24 weeks gestation have a mean AChE activity of 2,7 U/1 and those obtained at 26-40 weeks have a mean level of 0,6 U/l. Contamination of amniotic fluid with fetal or maternal blood was observed to elevate AChE activity leading to uninterpretable results. Assays in artificial mixtures of amniotic fluid with maternal or fetal blood confirm the risk related to added erythrocyte number. Higher mean AChE activity, 8 U/l, was observed in association with open NTD, but in 7 cases the level was as in normal pregnancy. Elevated levels of AChE were found in association with Turner's syndrome (1) and intra uterine death (2); no increase was observed in 7 cases of omphalocele or laparoschisis, in 6 cases of atresia and 2 cases of hydrocephaly. In practice frequent occurence of bloody samples, specially from abnormal pregnancies, limits application of the test for antenatal open NTD diagnosis. This test appears as and useful preliminary stage providing informations for realization and interpretation of gel electrophoresis of cholinesterases.
The qualitative acetylcholinesterase (AChE) test has been used in conjunction with alpha-fetoprotein (AFP) assay on 255 amniotic fluid samples: 191 from normal pregnancies, 44 from abnormal pregnancies (foetal anomalies or intrauterine death). In all cases of normal amniotic fluid obtained before 25 weeks, gel revealed a single major band of non specific cholinesterase, even in fluids contaminated by maternal of foetal blood, whereas 5 fluids contaminated by foetal blood were false positive on AFP. In 8 normal specimens with clear aspect, obtained after 25 weeks, gel revealed a second (AChE) faint band, inhibited by BW 284 C 51. That result shows the risk of false-positive for samples obtained in late pregnancy. All 20 cases of neural tube defect gave a characteristic AChE band: large and intense band. In 9 cases of abdominal wall defect, 3 presented an AChE faint band, just as 2 cases of atresia and 2 cases of hydronephrosis. Negative AChE results were found un 1 case of congenital nephrosis, 3 cases of hydrocephaly and 1 case of teratoma. The main value of qualitative AChE test seems today in diagnosing neural tube defects with a greater sensibility and in classifying bloody fluids in which the AFP is at or above the cut-off level.
Microsurgery has enabled modifications in initial surgical technique for lamellar scleral pocket and patch pocket on the posterior pole in the treatment of retinal detachments associated with macular holes occurring in high myopic eyes. The new microsurgical technique, employing suitable surgical instruments, was employed in 17 retinal detachments associated with macular holes. Surgical success was achieved in 14 cases (82 p. cent). The advantages and the disadvantages of lamellar scleral pocket and patch pocket on the posterior pole are discussed.
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Measurements are reported of NMR relaxation times (T2) on hydrogen in water of isotonic NaCl solutions and of normal human amniotic fluid in which known concentrations of meconium (fetal feces) were dissolved. Magnetic fields for resonance of 23.5 X 10(3) and 0.6 oersteds were used. From the measured T2 values, reliable estimates of meconium concentrations could be obtained that might be considered estimates of fetal distress. Observed minor variation of T2 values was probably due to the mucopolysaccharides comprising 80% of the meconium weight. Advantages of this technique for possible clinical use in obstetrics include small volume of sample required (0.1 ml), lack of necessity for sample filtration or centrifugation, and shortness of time required for analysis (less than 30 min).
Nineteen retinal detachments associated with large or giant retinal tears (70 degrees to 340 degrees) were treated by a microsurgical technique excluding vitrectomy. Reattachment of the retina was achieved in 15 patients (79 p. cent). Near normal visual acuity was achieved in 9 eyes. The anatomical and visual results achieved in this series lead the authors to discuss the specific problems involved in the treatment of retinal detachments associated with large or giant retinal tears. The indications for vitrectomy can be limited to those retinal detachments associated with a retinal tear involving more than 2 quadrants, and/or an inverted posterior margin reaching or covering the posterior pole, and/or a fixed retina and/or massive retraction of the anterior vitreous gel. In the clinical experience of the authors the cases which do not fulfil the previous criteria can be treated by a microsurgical technique excluding vitrectomy.
The relationship of dream content to the immediate pre- and post-sleep mentation of the dreamer was studied using the electrophysiologically defined state of REM (rapid eye movement sleep) as dream collection time. The subjects were 20 male and 20 female volunteers, ages 18 to 25. Each slept for three non-consecutive nights in the laboratory and had REM awakenings and pre- and post-sleep verbal content collected. REM reports and waking verbal samples were scored on 18 Hall-Van de Castle content scales. The interscorer agreement of two judges was 0.90. Product moment correlations were performed on each of the 18 content categories between content of the REM reports and of the waking verbal samples. Across all 40 subjects, 9 out of 18 correlations were statistically significant and 14 of the 18 were positive. The zero-mu test indicated that the distribution of the 18 correlations was significantly different from zero. Thus it can be concluded that dream content is related to the psychological parameters of waking life, in a continuous rather than compensatory manner.
Mechanism which underlie preparation for movement were studied in man using the method of 'monosynaptic tendon reflexes' during the preparatory period (PP) preceding the execution of ramp or ballistic tracking movements. Reflex reactivity is more important during the whole of the PP to a ramp rather than a ballistic movement; the increasing facilitation preceding the execution signal is greater and occurs earlier for the ramp than for the ballistic movement. These results were observed for 'fast' or 'slow' subjects in a reaction time task, but were more marked for the latter. On the one hand, preparation for movement is represented at the spinal level by a competition between activating influences, which allows for the speeding up of peripheral execution of central control, and inhibitory influences brought into play both by the need to suppress the movement until the execution signal and by the isolation of motor structures from postural proprioceptive servo-mechanisms. On the other hand, this preparation can imply a control of the level of activity in proprioceptive fusorial afferent pathways which depends on whether the movement to be executed is open-loop (ballistic) or closed (ramp). Comparison between the results obtained from fast and slow subjects underlines the importance of an active inhibitory process in spinal structures which would accompany temporal adjustment.
The records of 10 patients with cavernous choroidal hemangiomas were reviewed. Biomicroscopic findings were typical in all cases. Indocyanine green infrared angiography was performed on 8 patients. It showed typical and specific findings. Argon laser photocoagulation of the tumor was carried out in 6 cases with associated macular serous retinal detachment. Cryotreatment was applied in addition to argon laser photocoagulation in 2 cases wtih associated extensive bullous retinal detachment. Serious retinal detachment and macular edema completely resolved after treatment in 4 cases. Posttreatment visual acuity was the same as before treatment in 2 cases. In 4 cases it was improved.
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