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Biomedical subjects

R Navarro

Publications and source records attributed to R Navarro.

At least 73 records · Page 4Linked to original sources
PubMed1997

Foveal cone spacing and cone photopigment density difference: objective measurements in the same subjects.

Foveal cone spacing was measured in vivo using an objective technique: ocular speckle interferometry. Cone packing density was computed from cone spacing data. Foveal cone photopigment density difference was measured in the same subjects using retinal densitometry with a scanning laser ophthalmoscope. Both the cone packing density and cone photopigment density difference decreased sharply with increasing retinal eccentricity. From the comparison of both sets of measurements, the computed amounts of photopigment per cone increased slightly with increasing retinal eccentricity. Consistent with previous results, decreases in cone outer segment length are over-compensated by an increase in the outer segment area, at least in retinal eccentricities up to 1 deg.

Adult↗
PubMed1997

Aberrations and relative efficiency of light pencils in the living human eye.

We propose a new method for ray tracing in the living human eye. It consists of delivering a narrow light pencil from an unexpanded laser beam and recording the integrated energy and position of the aerial image formed by the outgoing beam (after reflection off the retina and passage through the fully open pupil of the eye and camera lens). The lateral displacement of the aerial image is proportional to the geometrical aberration (displacement) of the incoming ray at the retina. In addition, its integrated energy is proportional to retinal reflectance that is highly directional [related to the Stiles-Crawford (SC) effect and to the effective pupil transmittance]. This method permits us, by delivering rays through different equispaced positions at the pupil plane, to sample the complex pupil function: its magnitude is a measure of the effective pupil transmission and its phase is the wave aberration. Experimental results, aberrations, and reflectometric directionality for four subjects are consistent with previous findings.

Eye↗
PubMed1997

Shape of stars and optical quality of the human eye.

Star images are entoptic phenomena that most people can perceive when looking at bright point sources in darkness. Diffraction and/or ocular aberrations seem to be a plausible cause for the star patterns, but to our knowledge no objective recordings of retinal optical images showing these characteristic patterns have been reported before. We have projected a small Gaussian spot of light onto the retina and registered the aerial image formed externally through a fully dilated pupil [one-and-a-half-pass method [J. Opt. Soc. Am. A 12, 2385 (1995)]]. We have verified that, for fully dilated pupils (> 9 mm), the blur caused by the finite size of the Gaussian spot is small. Consequently, these aerial images are a reasonably good approximation of the (inverted) optical point-spread function of the eye. These objectively recorded images displayed the distinctive radiating patterns of star images, which were compared with subjective patterns sketched out by the same observers. A strikingly close match was found between the objective and the subjective patterns of the same eyes. In addition, we computed the diffraction patterns produced by a simple schematic model of the suture lines of the anterior lens surface, also obtaining star-shaped images. These results support the commonly accepted hypothesis of a purely optical origin of subjective star images.

Humans↗
PubMed1997

Determination of the foveal cone spacing by ocular speckle interferometry: limiting factors and acuity predictions.

We have developed a high-resolution imaging technique, based on speckle interferometry, for the objective determination of the cone spacing in the living human fovea. The spatial resolution attained with this technique is theoretically diffraction limited by the pupil size. However, the highest frequency that we measure varies greatly among subjects, especially for fully dilated pupils. We have conducted several experiments (determination of the cutoff frequency of ocular speckle interferometry, the double-pass modulation transfer function, and the Stiles-Crawford effect) that indicate that, as expected, the resolution is not limited by the incoherent modulation transfer function. We found, though, a high correlation between the cutoff frequency and the width of the eye's Stiles-Crawford function. This implies that the resolution depends on the structural properties of the cone mosaic itself. In addition, we have compared the Nyquist frequency of the cone mosaic, determined objectively by our technique, with the grating visual acuity measured in the same eyes at the same foveal eccentricities. For our subjects, visual resolution nearly matches the Nyquist frequency within the fovea, except at the foveal center, where the optical transfer function of the eye attenuates the contrast of frequencies close to the Nyquist limit to a value below threshold.

Cell Count↗
PubMed1997

Asthma.

Explore the source record for details and available documents.

Adolescent↗
PubMed1997

[Survival of patients with myasthenia gravis after thymectomy. Analysis of 100 cases].

In order to evaluate the survival of patients with myasthenia gravis (MG) after thymectomy (T), 100 patients with MG in which T had been performed between 1967 and 1995 were studied. Patients were divided into different groups for their analysis: patients with thymoma (TI), 22 cases; and patients without thymoma (NTI), 78 cases. In addition those patients belonging to the latter group were further separated according to the date of their surgery into two other subgroups: patients operated before 1980 (A80), 43 cases; and after 1980 (D80), 35 cases; trying to evaluate the prognostic implications of the therapeutical advances achieved over the last 15 years. The population studied was composed mainly of women (78%) but with a slight predominance of men in TI. The mean age was 29.47 years (range 10-70) for the entire population, with a tendency toward older ages in TI (mean 46 years, range 23-70). The mean follow-up period was 4.3 years (range 0.08-23.2) without significant differences between TI and NTI. The results showed that the overall mortality rate was 16/100 (16%) [Fig. 1], with nine of those deaths corresponding to TI (9/22, 40.91%) and only the remaining seven to NTI (7/78, 8.97%). These differences in mortality rate between TI and NTI were statistically significant in all the specific times of follow-up analyzed up to 10 years after surgery (p < 0.05) [Fig. 2]. Notoriously, all deaths in NTI occurred in the A80 subgroup giving a p value < 0.001 when compared with D80 [Fig. 3]. In terms of morbidity, 55/100 (55%) reached complete clinical remission (CCR) defined by the complete absence of symptoms related to MG: 8/22 (36.36%) in TI and 47/78 (60.25%) in NTI [Fig. 4]. Most interestingly the differences were statistically significant (p < 0.01) when the rates of CCR in A80 and D80 were compared for all the times assessed [Fig. 5-6-7-8]. It can be concluded that the best results in survival in MG after T are obtained in patients without thymoma and also that the benefits of the rational use of modern therapeutic modalities, including surgery and immunosuppression with drugs, can offer those patients high possibilities of leading completely normal lives.

Adolescent↗
PubMed1996

Off-axis optical quality and retinal sampling in the human eye.

Using the double pass procedure, Navarro et al. (1993; Journal of the Optical Society of America A, 10, 201-212) measured the monochromatic modulation transfer function (MTF) of the human eye as a function of retinal eccentricity. They chose conditions as similar as possible to those encountered in natural viewing. We report new measurements obtained with conditions chosen instead to optimize retinal image quality: we paralyzed accommodation, used a 3 mm pupil, and corrected defocus and oblique astigmatism at each retinal location. MTFs were estimated at the tangential focus, circle of least confusion, and sagittal focus produced by oblique astigmatism. Though optical blur is well-known to have little effect on peripheral visual acuity, it can nonetheless substantially reduce aliasing by receptoral and post-receptoral spatial sampling.

Adult↗
PubMed1996

Coherent imaging of the cone mosaic in the living human eye.

A new system for the recording of high-resolution images of the cone mosaic in the living room fovea has been developed. The experimental method is inspired by stellar speckle interferometry, used in astronomy to resolve binary stars. Series of short-exposure images of small areas of the fovea are registered under coherent illumination. These images show speckle patterns that have some correlation with the topography of the cone mosaic and retain high-resolution information. Such correlation is better revealed in the power spectrum (square modulus of the Fourier transform). The signal-to-noise ratio is increased, without loss of high frequencies, by averaging the power spectra of a number of such speckle patterns. The average power spectra show, in most of the cases, an elliptical ring (or hexagon), whose mean radius corresponds to the characteristic spatial frequency of the cone mosaic (or the inverse of the mean row-to-row cone spacing) at a given retinal location. Good results are obtained in the five normal observers tested, at various retinal eccentricities, up to 1 visual degree, including the center of the fovea for two eyes. We find a decrease in the spatial frequency of the mosaic with the eccentricity and an important intersubject variability, in agreement with anatomical studies.

Adult↗
PubMed1996

Effects of ear canal occlusion and masking on the perception of voice.

This study examined the effect of ear canal occlusion and masking noise on four parameters of voice: (1) average fundamental frequency, (2) intensity in decibel (dB), (3) maximum fundamental frequency observed in a given sample (max), and (4) minimum fundamental frequency observed in a given sample (min). 12 normal hearing undergraduates produced the vowel /i/ ten times under conditions of unoccluded ear canal, ear canal occluded with a sound attenuating earplug, or masking noise. Other than a small (.73 dB) decrease in intensity, analysis showed no significant changes under the occluded condition; however, the masking condition showed statistically significant increases in the fundamental frequency, the intensity, and the maximum and minimum frequency as well as an increased range of frequencies.

Adult↗
PubMed1996

Third autologous stem cell transplants for late relapse of multiple myeloma.

Double autologous bone marrow transplantation (ABMT) has been reported as an efficient form of consolidation for patients with multiple myeloma (MM). However, few data are available about feasibility and efficacy of a third ASCT in case of relapse. Here we report two patients with MM who received a third ASCT for late relapse (74 and 52 months) after a double ABMT. Both patients were male with IgG gamma MM (stage IIIA according to the Durie Salmon classification). The two patients were in PR > 50% after a first-line treatment. A double ABMT was performed after relapse and patients remained in PR > 50% after double intensification, lasting 71 and 49 months, respectively. The third ASCT was performed 7 and 10 months, after second relapse. One patient needed 15 months to reach 50 000 platelets, however he did not receive any transfusion after day 14. He was in PR > 50%. The other patient was in PR < 50%, 4 months after ABMT with a full hematological reconstitution. For patients with late relapse of MM after double ABMT, a third ABMT was a feasible treatment and patients seem to remain sensitive to high-dose therapy.

Adult↗
PubMed1996

[Lawsuits against physicians in Chile].

Lawsuits against are becoming relevant in Chile. We analyzed 18 trials against physicians that occurred between 1977 and 1985 and that were ruled by Metropolitan Region courts. The causes of demands were death of patients in 8 trials and severe lesions in the rest. Twelve trials originated from surgical procedures (six from gynecological interventions), and nine came from private clinics. Nine trials lasted less than two years and three, more than 5 years. Sentence was pronounced by criminal courts in 12 cases and by appealing courts in six.

Chile↗
PubMed1995

alpha-Interferon therapy for congenital dyserythropoiesis type I.

We report the case of a 28-year-old female followed for congenital dyserythropoiesis type I which required repeated transfusions. Alpha-2a interferon treatment was started because of post-transfusion chronic viral hepatitis type C. Following this treatment, haemoglobin level increased and reached normal value during the 24 weeks of interferon treatment. When interferon therapy was stopped, haemoglobin level returned to previous values, requiring more transfusions. Resumption of interferon therapy resulted again in a complete normalization of haemoglobin level. Erythrokinetic studies demonstrated a striking reduction of the ineffective erythropoiesis, and electron microscopy study a reduction in nuclear structure abnormalities. To our knowledge, this is the first report of the efficacy of interferon in congenital dyserythropoiesis.

Adult↗
PubMed1995

Odd aberrations and double-pass measurements of retinal image quality.

We investigated the formation of the aerial image in the double-pass method to measure the optical quality of the human eye. We show theoretically and empirically that the double pass through the eye's optics forces the light distribution in the aerial image to be an even-symmetric function even if the single-pass point-spread function is asymmetric as a result of odd aberrations in the eye. The reason for this is that the double-pass imaging process is described by the autocorrelation rather than the autoconvolution of the single-pass point-spread functions, as has been previously assumed. This implies that although the modulation transfer function can be computed from the double-pass aerial image, the phase transfer function cannot. We also show that the lateral chromatic aberration of the eye cannot be measured with the double-pass procedure because it is canceled by the second pass through the eye's optics.

Humans↗
PubMed1995

Phase transfer and point-spread function of the human eye determined by a new asymmetric double-pass method.

A recent study has shown that the double-pass method provides a good estimate of the ocular modulation transfer function (MTF) but that it does not yield the phase transfer function (PTF) [J. Opt. Soc. Am. A 12, 195 (1995)]. Therefore, one cannot recover the true retinal point-spread function (PSF). We present a modification of the double-pass method to overcome this problem. The key is to break the symmetry between the two passes. By using an unexpanded Gaussian input beam, we produce a diffraction-limited PSF for the first passes. Then, by using a large exit pupil, we get an aberrated PSF for the second pass. The double-pass aerial image is the cross correlation of both PSF's, so that the Fourier transform of such an aerial image directly provides the true retinal PTF, up to the cutoff frequency of the effective (small), diffraction-limited entrance pupil. The resulting double-pass aerial image is a blurred version of the true retinal PSF. Thus it shows the effect not only of even symmetric aberrations but also of odd and irregular aberrations such as coma. We have explored two different ways to retrieve the true retinal PSF: (a) deblurring of the aerial image and (b) PSF reconstruction combining PTF data with conventional double-pass MTF. We present promising initial results with both artificial and real eyes.

Humans↗
PubMed1995

Antidepressant utilization in managed care: an evaluation of SSRI use in two HMO settings.

Antidepressant costs and utilization are growing rapidly as newer selective serotonin reuptake inhibitors (SSRIs) comprise an ever-increasing share of the market. A number of factors and related costs must be considered when evaluating antidepressant products. An antidepressant drug utilization review study performed in two different HMO models revealed important variations among available SSRI therapies in terms of dosage escalation and discontinuation, as well as concomitant medication costs associated with treating side effects. New antidepressants may alleviate some of these problems.

1-Naphthylamine↗
PubMed1994

Humans anesthetized with sevoflurane or isoflurane have similar arrhythmic response to epinephrine.

BACKGROUND: Anesthetics can alter the dose of exogenously administered epinephrine that causes cardiac arrhythmias. The purpose of this study was to test the hypothesis that in humans anesthetized with sevoflurane, the arrhythmic response to epinephrine is not different from the response in humans anesthetized with isoflurane. METHODS: We determined the arrhythmogenicity of submucosally administered epinephrine in 40 ASA physical status 1 or 2 patients who were to undergo transsphenoidal surgery. Patients were assigned randomly to be given 1.0-1.3 minimum alveolar concentration sevoflurane or isoflurane. A surgeon, blinded to the anesthetic and the concentration of epinephrine, injected into the nasal submucosa epinephrine 10, 13.3, or 20 micrograms/ml in saline of volume sufficient for surgical need. We defined a "positive" response as three or more premature ventricular contractions within 5 min after initiation of injection. Responses between anesthetic groups within each dose range of epinephrine were compared by chi-squared analysis. RESULTS: No patient given either anesthetic developed premature ventricular contractions with doses of epinephrine less than 5 micrograms/kg. At larger doses of epinephrine (5-9.9 and 10-14.9 micrograms/kg), the frequency of arrhythmias did not differ between patients given sevoflurane and patients given isoflurane. Patients anesthetized with 1.2 minimum alveolar concentration sevoflurane had blood pressure similar to and heart rate less than those of patients anesthetized with similar concentrations of isoflurane. Blood pressure and heart rate were increased similarly in both groups after laryngoscopy and tracheal intubation and after epinephrine injection. CONCLUSIONS: Sevoflurane and isoflurane do not differ in their sensitization of the human myocardium to the arrhythmogenic effect of exogenously administered epinephrine.

Adult↗