[Reformation of the retinal capillary bed of the posterior pole after panretinal photocoagulation].
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Biomedical subjects
Publications and source records attributed to M Bonnet.
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E.O.G. have been performed before and after panretinal photocoagulation (P.R.P.) on 71 eyes with proliferative diabetic retinopathy. After the P.R.P., the L/D raio is abnormal in 100 % of the eyes. Nevertheless, the L/D ratio was already abnormal in 75 % of the eyes and decreased in 12 % of the eyes before the P.R.P. Thus the impairment of E.O.G. resulting from P.R.P. appears to be a relatively slight sacrifice if compared to the benefit of the treatment.
Dark adaptation has been studied on 73 eyes of 50 patients before and after pan retinal photocoagulation. In this series dark adaptation of 23 eyes out of 73, 35,6 %, has become abnormal after P.R.P.
From an observation, authors underline the interest of two complementary tests: ultrasonography and amniotic fluid AFP determination. About the reported case, the chronology of facts is unusual: ultrasonography led initially to suspect anomaly, then elevated AFP result confirmed the malformation.
405 children with acute lymphoblastic leukemia were stratified according to age, initial leucocytes count, lymph nodes, liver and spleen size, into three prognostic classes I, II, III. Protocol 08 LA 74 which they were applied included: 1)initial randomization between Prednisone, Vincristine, Daunorubicin or the same plus Cyclophosphamide for induction and reinductions; 2)doses adjustments to prognostic factors, increased doses being given to increased risk patients; 3)comparison between intrathecal Methotrexate and intrathecal Methotrexate plus Ara-C in addition to skull irradiation for CNS prophylaxis; 4)L-Asparaginase consolidation for all patients; 5)maintenance by 6-Mercaptopurine and Methotrexate in all patients and reinductions. The most striking conclusions to date are the improvement for increased risk patients, the frequency of primary testicular relapses contrasting with the low rate of meningitis, the prognostic implication of sex, the influence on remission duration of the number of courses necessary to achieve complete remission, the importance of using Cox Method to improve the identification of prognostic groups.
The argon laser manufactured by the firm Biophysic Medical has been adapted on the mobile slit lamp of the surgical microscopes OPMI 1 nad OPMI 6 manufactured by K. Zeiss. The apparatus is described. The main indications for its utilization are dealt with.
7 patients affected by recurrent retinochoroiditis certainly or probably due to toxoplasma Gondii underwent immunotherapy by B.C.G. The follow-up after immunotherapy varied from 14 months to 50 months with an average of 28 months. 5 out of the 7 patients (71%) had recurrences of the retinochoroiditis 2 months to 3 years after the treatment. Even though the series is small, the results are so discouraging that we do not recommend to go further with this technique. At present we try other forms of immunotherapy. Assessment of their value will require a 5 years follow-up.
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Certain macular lesions which impair the visual results of successful retinal detachment surgery result from the treatment itself. The causes of the macular lesions due to surgery are reviewed. The incidence of those lesions is likely to be decreased by microsurgery which allows for a well controlled surgery. In a series of 100 consecutive retinal detachments successfully operated on by microsurgery--out of 111 consecutive cases operated on--visual acuity of 5/10 or Better was achieved in 45% of the cases, and reading acuity of Parinaud 3 or Better was achieved in 70% of the cases. Neither macular pigment migration nor macular hemorrhage were observed in this series. Nevertheless the incidence of macular pucker due to surgery is 2% and the incidence of cystoid macular edema is 3%. As the incidence of the latter complications is lower in this series than in a previous series the authors believe that the frequency of the macular complications of retinal detachment surgery should be even lower in future with a wider experience of microsurgery.
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The level of placental alpha-fetoprotein (AFP) in normal pregnancy at term was found to be 5050 +/- ng/g fresh tissue. A significant increase was noted in the toxemic placenta associated with a rise in circulating maternal AFP level and a nonsignificant increase in cord blood. The increase in maternal AFP level in cases of premature delivery before 33 weeks' gestation and postmature delivery after 40 weeks' gestation predicted that maternal AFP measurement throughout the second and third trimester of pregnancy could be clinically established as an index of placental function.
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Biomicroscopy of the fundus during retinal detachment surgery has the same advantages as indirect ophthalmoscopy. In addition to this, it offers three main advantages over indirect ophthalmoscopy: the observation of the fundus, in an optical cross section of the tissues, the high variation of magnification available, and the observation of the fundus without switching off the light of the operating room. Since 1976--biomicroscopy of the fundus during retinal detachment surgery has been easily performed with the surgical mobile slit lamp manufactured by the firm Zeiss. The angle of the surgical slit lamp can be reduced to 5 degrees. The slit lamp can be used either with the Zeiss OPMI 1 operating microscope or with the Zeiss OPMI 6 operating microscope. The microscope, the contact lens and the surgical instrumentation specialy fitted for biomicroscopy of the fundus during retinal detachment surgery are described. The surgical technique is dealt with, pointing out the practical details which allow for overcoming the own difficulties of biomicroscopy of the fundus during surgery.
A fluorescein angiography of the optic disc has been performed on 62 eyes in 41 patients suffering from ocular hypertension or glaucoma. The angiogram was abnormal in 32 eyes. 11 eyes showed an absolute hypofluorescence involving the whole optic disc. 15 eyes showed an absolute hypofluorescence limited to a part of the cup and the rim. 6 eyes showed a late hyperfluorescence of the fundus of the cup. Total hypofluorescence throughout all phases of fluorescein angiogram corresponds to filling defects. Absolute hypofluorescence involving the whole optic disc is associated with visual field loss in all cases. Absolute hypofluorescence involving only an area of the optic disc is associated with a normal visual field in a few cases. It is postulated that the limited filling defects without visual fields defects may be an indication of impending loss of the visual field. Therefore fluorescein angiography could be helpful in clinical assessment of visual prognosis of chronic ocular hypertension and glaucoma. Nevertheless wider experience and followup are necessary to confirm the value of the method.
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