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Terminal gas velocity during laparoscopy.

STUDY OBJECTIVE: To assess the effect of port size in relation to laparoscopic gas flow and to determine the terminal velocity of gas flow during insufflation. DESIGN: Analysis and mathematical modeling of gas flow characteristics. SETTING: University biomedical engineering department. INTERVENTION: Analytic calculations including Bernoulli's equation to describe gas volumetric flow and velocity as it exits laparoscopic intraabdominal entrance sites. MEASUREMENTS AND MAIN RESULTS: Mathematical modeling showed that terminal velocity of gas entering the abdomen through needles or trocars reaches a practical limit depending on size and configuration of the gas exit site, amount of turbulence, length of delivery port, and gas flow. Flow rate was evaluated for circles of 2, 5, and 10 mm and annular slots of 0.1- to 0.01-mm thickness. CONCLUSION: Resistance to gas flow increases and gas exiting terminal velocity increases as the effective area of the gas exit site decreases. Depending on the configuration of variable parameters, gas flow can reach 30 m/second.

Biophysical Phenomena↗

Inspired gas temperature during mechanical ventilation: effects of environmental temperature and airway temperature probe position.

OBJECTIVES: To determine the inspired gas temperature during mechanical ventilation with: (i) five different humidicrib temperatures; (ii) two airway temperature probe (ATP) positions; and (iii) four ATP adaptors. METHODOLOGY: An observational study in the Neonatal Intensive Care Laboratory, Westmead Hospital. The inspired gas temperature was measured at the proximal end of the endotracheal tube (ETT) during conventional mechanical ventilation using a Tele-thermometer. Inspired gas temperature measurements were made with: (i) the humidicrib temperature set at 30.8. 32.9, 35.2, 36.2. or 37.2 degrees C; (ii) the ATP either (A) positioned inside the humidicrib at the distal end of the inspiratory tubing or (B) positioned outside the humidicrib 50 cm proximal to the ETT, with the inspired gas temperatures set at 36.5 and 39.0 degrees C, respectively; and (iii) the measurements repeated with four different ATP adaptors at each humidicrib temperature and each ATP position. RESULTS: With the ATP inside the humidicrib, there were no significant differences between set and actual inspired gas temperature. However, with the ATP outside the humidicrib, there were significant decreases in inspired gas temperature at each humidicrib temperature. For instance, with the ATP outside the humidicrib and set at 39.0 degrees C, the inspired gas temperature decreased to 34.7+/-0.2 degrees C at a humidicrib temperature of 30.8 degrees C and to 37.7+/-0.2 degrees C at a humidicrib temperature of 37.2 degrees C. The type of ATP adaptor also had a significant effect on inspired gas temperature. CONCLUSIONS: With the ATP placed outside the humidicrib and with variations of humidicrib temperature, infants are likely to have inspired gas temperatures that are significantly different to the desired temperature. Certain ATP adaptors cause these variations in inspired gas temperature to be more pronounced. Extreme care must be used to avoid suboptimal inspired gas temperatures with these environmental variations and the ATP positioned outside the humidicrib.

Environment, Controlled↗

Prokinetic effects in patients with intestinal gas retention.

BACKGROUND & AIMS: We have previously shown that patients with irritable bowel syndrome (IBS) have impaired transit of intestinal gas loads. Because abnormal gas retention can be experimentally reproduced in healthy subjects by pharmacological inhibition of gut motility, we hypothesized that impaired gas transit and retention can be reciprocally corrected by pharmacologically stimulating intestinal propulsion. METHODS: In 28 patients with abdominal bloating (14 IBS, 14 functional bloating) and in 14 healthy subjects, gas evacuation and perception of jejunal gas infusion (12 mL/min) were measured. After 2 hours, in 20 patients we tested the effect of intravenous neostigmine (0.5 mg) vs. intravenous saline administered blindly and randomly at a 1-hour interval. RESULTS: After 2 hours of gas infusion, patients with IBS and functional bloating alike exhibited significant gas retention (418 +/- 86 mL), abdominal symptoms (2.7 +/- 0.5 score), and objective distention (8 +/- 2 mm girth increment), in contrast to healthy controls, who experienced none (46 +/- 102 mL retention, 0.4 +/- 0.3 symptom score, and 3 +/- 1 mm distention; P < 0.05 for all). Neostigmine produced immediate clearance of gas retained within the gut (603 +/- 53 mL/30 minutes vs. 273 +/- 59 mL/30 minutes after saline; P < 0.05) and by 1 hour reduced gas retention (by 373 +/- 57 mL), abdominal symptoms (by 1.1 +/- 0.5 score), and distention (by 6 +/- 1 mm; P < 0.05 for all), whereas intravenous saline produced no effects. CONCLUSIONS: In patients with intestinal gas retention, pharmacological stimulation of intestinal propulsion improves gas transit, abdominal symptoms, and distention.

Abdomen↗

Parallel temperatures in supersonic beams: ultracooling of light atoms seeded in a heavier carrier gas.

Supersonic expansion is a very powerful tool to produce an atomic beam with a well defined velocity and, by seeding a test gas in such an expansion, the energy of the test gas can be transferred, at least partially, to the very-low-temperature carrier gas. The case usually studied is the one of a heavy gas seeded in a light carrier gas and, in this case, the parallel temperature of the seeded gas is always larger than the one of the carrier gas. In the present paper, we study the opposite case which has received less attention: when a light gas is seeded in a heavier carrier gas, the parallel temperature can be substantially lower for the seeded gas than for the carrier gas. This effect has been first observed by Campargue and co-workers in 2000, in the case of atomic oxygen seeded in argon. In the present paper, we develop a theoretical analysis of this effect, in the high dilution limit, and we compare our theoretical results to several experimental observations, including a set of measurements we have made on a beam of lithium seeded in argon. The agreement between theory and experiments is good.

Journal Article↗

Visual outcomes of silicone oil versus gas tamponade for macular hole surgery.

PURPOSE: To determine the effectiveness of silicone oil versus gas tamponade to treat macular holes. METHODS: A retrospective review of patients who underwent macular hole repair with either silicone oil or gas tamponade. RESULTS: Data collected from 66 eyes from a retina only practice (Retina and Vitreous of Texas) were reviewed to assess visual outcomes of surgery with silicone oil versus 14% C3F8 gas tamponade. 21 eyes were non-randomized to silicone oil tamponade and 45 eyes underwent gas tamponade. The average overall follow-up time was 11.8 months. Stage 2 holes constituted 9% of the holes; stage 3 and 4 made up 75%; recurrent holes were 11%; and 5% were traumatic holes. Of the macular holes not treated previously, 81.3% (13 of 16) were sealed successfully with silicone oil tamponade while 83.7% (36 of 43) of the gas-treated eyes were sealed. The overall primary closure rate was 83.1% (49 of 59). The pre-operative decimal visual acuity was 0.104 (20/192) for the silicone oil group and 0.193 (20/104) for the gas-treated group. The post-operative decimal visual acuity at 1 year was 0.208 (20/96) for the silicone oil group and 0.453 (20/44) for the gas-treated group. The reopening rate for the silicone oil group was 14% (3 of 21) and 9% (4 of 45) for the gas-treated group. The need for cataract surgery post macular hole repair was 36% (4 of 11 phakic patients) for the silicone oil group and 61% (17 of 28 phakic patients) for the gas-treated group. CONCLUSIONS: With short-term follow-up silicone oil tamponade and gas tamponade are both successful in anatomic closure of macular holes. In eyes with macular holes surgically repaired with gas tamponade significant improvements in visual acuity are seen more frequently than eyes treated with silicone oil tamponade. Toxicity of silicone oil to the retinal pigment epithelium and/or photoreceptors may play a role in these results.

Aged↗

The relationship between in vitro gas production, in vitro microbial biomass yield and 15N incorporation and its implications for the prediction of voluntary feed intake of roughages.

The relationship between in vitro gas production, concomitant in vitro apparent and true DM degradability has been examined in forty-two roughages. The partitioning of truly-degraded substrate between gas volume and microbial biomass yield and 15N incorporation into cells was also investigated. The relevance of this partitioning for the regulation of DM intake (DMI) was examined for fifty-four roughages. The results can be summarized as follows. In vitro gas production and in vitro apparent and true degradability are highly correlated (P < 0.0001), r being 0.96 and 0.95 respectively. There is an inverse relationship between in vitro gas production and microbial biomass yield (r--0.67, (P < 0.0001) and also 15N enrichment (P < 0.001) when the variables were related to a given unit of substrate truly degraded. Selecting roughages by in vitro gas production may well be a selection against maximum microbial yield and a combination of in vitro gas volume measurements with a complementary determination of the substrate truly degraded is proposed, to calculate a partitioning factor (PF) reflecting the variation of short-chain fatty acid production per unit substrate degraded. PF is calculated as the ratio, substrate truly degraded: gas produced by it. PF was highly significant (P < 0.0001) in DMI prediction when included in stepwise multiple correlations together with in vitro gas volume variables reflecting the extent and rate of gas production; 11% of the variation in DMI was accounted for by the PF. The total model, including extent and rate of gas production and the PF, accounted for 84% of the variation in DMI. Roughages producing proportionally less gas per unit substrate truly degraded had higher feed intakes.

Animal Feed↗

Which is the best method to trace group A streptococci in sore throat patients: culture or GAS antigen test?

OBJECTIVE: To compare an antigen detection test (GAS antigen test) with the results from combinations of two various bacteriological test media in general practice patients with sore throat. Furthermore to assess the diagnostic properties of the chosen GAS antigen test and to compare semi-quantitative results of this test with the bacterial load found in the throat culture. SETTING: Two Norwegian general practices in Stokke and Kongsberg communities. SUBJECTS: 306 patients with sore throat lasting less than 7 days; 244 were adults, 62 were children under 10 years old, mean age 23.9 years (SD 15.0), 40% were men. MAIN OUTCOME MEASURES: Results from GAS antigen test, and distribution of bacteriological findings in throat cultures, compared with the results of our GAS antigen test; semi-quantitative results of the GAS antigen test compared with the bacterial load by culture. RESULTS: In the primary culture 110 patients harboured group A streptococci (GAS) infection, while the second culture identified another 17, giving a total of 127 patients. Some 33 patients harboured large-colony groups C and G. The GAS antigen test used had a sensitivity of 97% and specificity of 95% regarding GAS when compared with the two cultures. We found a significant correlation between the bacterial loads by culture and the semi-quantitative results of the GAS antigen test. CONCLUSIONS: By using a second, different set of bacteriological media, we identified an additional 17 patients with GAS infections. This raises the question of validity of frequently used reference standards in studies related to streptococcal infections. Compared with the combined results of the two throat cultures, the GAS antigen test used showed high sensitivity and specificity. Semi-quantitative evaluations of the rapid immunological test may also be of clinical value.

Adolescent↗

A cost-effective and versatile xenon gas dispenser.

OBJECTIVE: To modify a commercial xenon gas dispenser so that two xenon unit-dose vials could be combined with a modified dispenser to deliver a recommended dose. METHOD: To maintain the same operating mechanism, changes were made only to the vial shield and the needle port of the original gas dispenser. The modified gas dispenser consisted of two puncture needles and two vial holders shielded with the same thickness of lead as the commercial dispenser. RESULTS: Our evaluation showed that the modified gas dispenser operated the same way as the commercial unit, and the average 133Xe residual activity in either one or two xenon unit-dose vials of the modified gas dispenser was not significantly different from that in one vial of the commercial xenon gas dispenser. CONCLUSION: The modified xenon gas dispenser allows the stock of xenon gas vials to be managed cost-effectively. The modified unit can be used to dispense two low-activity xenon gas vials to deliver a standard dose to a patient. Also, the modified gas dispenser can be used to combine different amounts of xenon activity in two unit-dose vials in order to customize the dose delivered to patients with special needs (e.g., obese patients). Our modified device can also function as a single-dose dispenser by placing an empty vial alongside the unit-dose vial of radioactive xenon gas.

Administration, Inhalation↗

Nonideal gas flow and heat transfer in micro- and nanochannels using the direct simulation Monte Carlo method.

Subsonic nonideal gas flow and heat transfer in micro- and nanochannels for different Knudsen numbers are investigated numerically using the direct simulation Monte Carlo method modified with a consistent Boltzmann algorithm. The van der Waals equation is used as the equation of state. The collision rate is also modified based on the Enskog theory for dense gas. It is shown that the nonideal gas effect becomes significant when the gas becomes so dense that the ideal gas assumption breaks down. The results also show that the nonideal gas effect is dependent not only on the gas density, but also on the channel size. A higher gas density and a smaller channel size lead to a more significant nonideal gas effect. The nonideal gas effect also causes lower skin friction coefficients and different heat transfer flux distributions at the wall surface. The simulations presented in this work are helpful for a better understanding of micro- and nanoscale gas flows.

Journal Article↗

A highly sensitive, flow through h(2) gas analyzer for use in nitrogen fixation studies.

Studies of H(2) evolution by N(2) fixing systems are frequently limited by an inability to accurately measure H(2) gas concentrations of less than about 10 microliters per liter. In this study, a H(2) gas analyzer is described which is able to accurately and reproducibly detect up to 100 times lower H(2) concentrations than most thermal conductivity gas chromatographs or other conventional instruments used for the measurement of H(2) gas. This high level of sensitivity (maximum of about 0.02 microliter per liter H(2) per millivolt output) and the ability to continuously monitor H(2) concentration directly in a flowing gas stream, makes this instrument well suited for use in an open gas exchange system.Since the sensor used in the instrument was also sensitive to other combustible gases, it was necessary to demonstrate that H(2) was the only combustible gas produced by the N(2) fixing system being studied. When an air stream was passed through a pot containing nodulated soybean (Glycine max L.) roots, gas chromatographic analysis of the effluent gas stream revealed that H(2) was the only combustible gas present. These results were supported by other studies in which no combustible gases were detected in the effluent gas stream from soybean roots nodulated with USDA 110, a Rhizobium strain which displays active uptake hydrogenase activity.

Journal Article↗

Impaired small bowel gas propulsion in patients with bloating during intestinal lipid infusion.

OBJECTIVE: In healthy individuals, intraluminal lipids delay intestinal gas clearance, and this reflex is exaggerated in patients with irritable bowel syndrome (IBS). Our aim was to determine the site of action of abnormal lipid-induced reflexes in IBS. METHODS: In six patients with (IBS) predominantly complaining of bloating and in six healthy subjects, a mixture of gas (N2, O2, and CO2 in venous proportions to minimize diffusion) was infused (12 mL/min) either into the jejunum or into the ileum for 2 h, with simultaneous perfusion of lipids (0.5 kcal/min) into the proximal duodenum. Rectal gas evacuation was measured by a barostat. Abdominal perception (by a 0-6 scale) and girth changes were measured at 15-min intervals. The effects of jejunal versus ileal gas infusion were compared by paired tests in random order on separate days. RESULTS: IBS patients exhibited significant gas retention during infusion of gas into the jejunum (398 +/- 90 mL vs-210 +/- 105 mL in health, p < 0.05) but not during ileal infusion (-79 +/- 87 mL vs-79 +/- 78 mL in health, NS; p < 0.05 vs jejunal infusion). Gas retention during jejunal gas infusion in IBS patients was associated with significant abdominal distension (11 +/- 3 mm girth increment vs 0 +/- 1 mm during ileal gas infusion and 1 +/- 1 mm in health, p < 0.05 for both) and abdominal symptoms (3.6 +/- 0.6 score vs 2.6 +/- 0.7 score during ileal gas infusion and 1.6 +/- 0.5 score in health, p < 0.05 for both). CONCLUSIONS: In IBS patients intraluminal lipids impair intestinal gas clearance because of upregulated reflex inhibition of small bowel transit, without appreciable colonic effects.

Adult↗

Intestinal gas distribution determines abdominal symptoms.

BACKGROUND: Patients with functional gut disorders manifest poor tolerance to intestinal gas loads but the mechanism of this dysfunction is unknown. AIM: Our aims were firstly, to explore the relative importance of the amount of intestinal gas versus its distribution on symptom production, and secondly, to correlate gut motility and perception of gas loads. SUBJECTS: Fourteen healthy subjects with no gastrointestinal symptoms. METHODS: In each subject a gas mixture was infused (12 ml/min) either into the jejunum or rectum for one hour during blocked rectal gas outflow, and subsequently gas clearance was measured over one hour of free rectal evacuation. We measured abdominal perception, distension, and gut tone by duodenal and rectal barostats. RESULTS: Similar magnitude of gas retention (720 ml) produced significantly more abdominal symptoms with jejunal compared with rectal infusion (perception score 4.4 (0.4) v 1.5 (0.5), respectively; p<0.01) whereas abdominal distension was similar (15 (2) mm and 14 (1) mm girth increment, respectively). Jejunal gas loads were associated with proximal contraction (by 57 (5)%) and colonic loads with distal relaxation (by 99 (20)%). CONCLUSION: The volume of gas within the gut determines abdominal distension whereas symptom perception depends on intraluminal gas distribution and possibly also on the gut motor response to gas loads.

Abdomen↗

Gas 6 promotes Axl-mediated survival in pulmonary endothelial cells.

We examined Gas 6-Axl interactions in human pulmonary artery endothelial cells (HPAEC) and in Axl-transduced HPAEC to test Gas 6 function during endothelial cell survival. We identified the 5.0-kb Axl, 4.2-kb Rse, and 2.6-kb Gas 6 mRNAs in HPAEC. Immunoprecipitation and Western blotting confirmed the presence of these proteins. Gas 6 is present in cell-associated and secreted fractions of growth-arrested HPAEC, independent of cell density. In addition, the Axl receptor is constitutively phosphorylated in growth-arrested cultures, and exogenous Gas 6 enhanced Axl phosphorylation threefold. Gas 6 added to growth-arrested HPAEC resulted in a significant increase in cell number (1.5 nM Gas 6 increased cell number 35%). Flow cytometry revealed that Gas 6 treatment resulted in 28% fewer apoptosing cells. Transduction of a full-length Axl cDNA into HPAEC resulted in 54% fewer apoptosing cells after Gas 6 treatment. Collectively, the data demonstrate antiapoptotic activities for Gas 6 in HPAEC and suggest that Gas 6 signaling may be relevant to endothelial cell survival in the quiescent environment of the vessel wall.

Animals↗

Time course of bronchoconstriction induced by dry gas hyperpnea in guinea pigs.

We examined the effects of hyperpnea duration and abrupt changes in inspired gas heat and water content on the magnitude and time course of hyperpnea-induced bronchoconstriction (HIB) in anesthetized mechanically ventilated male Hartley guinea pigs. In 12 animals subjected to 5, 10, and 15 min (random order) of dry gas isocapnic hyperpnea [tidal volume (VT) 4-6 ml, 150 breaths/min) followed by quiet breathing of humidified air (VT 2-3 ml, 60 breaths/min), severe bronchoconstriction developed only after the cessation of hyperpnea; the magnitude of respiratory system resistance (Rrs) increased with the duration of dry gas hyperpnea [peak Rrs 1.0 +/- 0.2, 1.8 +/- 0.3, and 2.3 +/- 0.3 (SE) cmH2O.ml-1.s, respectively]. Seven other guinea pigs received, in random order, 10 min of warm humidified gas hyperpnea, 10 min of room temperature dry gas hyperpnea, and 5 min of dry gas hyperpnea immediately followed by 5 min of warm humidified gas hyperpnea. After each hyperpnea period, the animal was returned to quiet breathing of humidified gas. Rrs rose appreciably after the 10 min of dry and 5 min of dry-5 min of humidified hyperpnea challenges (peak Rrs 1.3 +/- 0.2 and 0.7 +/- 0.2 cmH2O.ml-1.s, respectively) but not after 10 min of humidified hyperpnea (0.2 +/- 0.04 cmH2O.ml-1.s). An additional five animals received 10 min of room temperature dry gas hyperpnea followed by quiet breathing of warm humidified air and 10 min of room temperature dry gas hyperpnea followed by 30 min of warm humidified gas hyperpnea in random order.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗

Gas distribution in intraabdominal and pelvic abscesses on CT is associated with drainability.

OBJECTIVE: Intraabdominal and pelvic abscesses are treated by percutaneous image-guided drainage, under sedation or general anesthesia. This study attempts to determine if the CT features of gas distribution are associated with "drainability." Our premise was that gas may be trapped deep in a collection as bubbles, if the material is thick. Gas may rise to the surface if the material is thin, forming either an air-fluid level or superficial bubbles. MATERIALS AND METHODS: Patients with intraabdominal and pelvic abscesses were identified by the interventional radiology database, after research ethics board approval. Patients without prior CT were excluded. The imaging and clinical records were analyzed retrospectively. Intracollection gas distribution was recorded as superficial bubbles, deep bubbles, or air-fluid levels. Collections were classified accordingly: type 1, air-fluid levels; type 2, superficial or deep bubbles and air-fluid levels; type 3, superficial bubbles; type 4, deep bubbles; and type 5, no gas. RESULTS: One hundred five abscesses were examined in 61 patients, ranging in age from 2-17 years. Eight of 8 of type 1, 16 of 16 of type 2, 19 of 21 of type 3, 8 of 13 of type 4, and 43 of 47 of type 5 were drainable. The abscesses of all patients with an air-fluid level were drainable. Of abscesses with deep bubbles, 61.5% were drainable, versus 90.5% of those with superficial bubbles. Of those with superficial gas (superficial bubbles or air-fluid levels), 95.6% were drainable. In comparison with superficial gas, abscesses with deep trapped gas were associated with a longer duration of drainage, longer hospital stay, lower percentage of successful drainage, and higher percentage of residual collections. The difference is significant for drainability (p = 0.0048; p = 0.0331 after statistical adjustment for multiple testing). CONCLUSION: Distribution of gas in an intraabdominal or pelvic abscess is associated with drainability. Abscesses with superficial gas (superficial bubbles or air-fluid levels) have a greater chance of being drained successfully than do abscesses with deep trapped gas.

Abdominal Abscess↗

Influence of brine concentration, brine temperature, and presalting on early gas defects in raw milk pasta filata cheese.

Thirty-one 3.8-kg blocks of Ragusano cheese were made on each of 6 d starting with a different batch of raw milk on each day. On d 1, 3, and 5, cheeses were not presalted and on d 2, 4, and 6, all cheeses were presalted. Before brine salting, one of the 31 blocks of cheese was selected at random for analysis (i.e., at d 0). The remaining 30 blocks were randomly divided into 2 batches of 15 blocks each, one group was placed in 18% brine, and the other group was placed in saturated brine. For the 15 blocks within each of the 2 brine concentrations, 5 blocks each were placed in brine tanks at 12, 15, and 18 degrees C. Cheese blocks were sampled immediately before brine salting (d 0) and after 1, 4, 8, 16, and 24 d of brine salting. Presalting the curd with 2% added salt before stretching reduced the coliform count in the cheese by 1.41 log and resulted in a major reduction in early gas formation. Across all treatments in the present study, the average reduction in gas formation due to presalting was 75%. Reducing brine temperature had the second largest impact on reducing gas production, but did not reduce the coliform count in the cheese. Reducing brine temperature from 18 to 12 degrees C made a larger reduction in early gas formation in cheeses that were not presalted (from 6.8 to 1.8% gas holes, respectively) than in cheeses that were presalted (from 1.9 to 0.5% gas holes, respectively). To achieve the same absolute level of gas production in the nonpre-salted cheese as was achieved in presalted cheese in combination with 18 degrees C brine, the brine temperature for the nonpresalted cheese had to be lowered from 18 to 12 degrees C. Reducing brine concentration, although effective at increasing the rate of salt penetration into the block, did not have any impact on coliform count and had minimal impact on reducing gas production. The condition where reducing brine concentration was able to make a reduction in gas production was for cheeses that were not presalted and brined at 18 degrees C. Presalting is a very simple and practical approach to reducing the problem of early gas formation in combination with strategies to improve milk quality and cheese making conditions. Further work is needed to understand the impact of different levels of presalting on death of coliforms and gas production in the cheese.

Cheese↗

Clinical effect of blowing nitrogen gas across the cornea during photorefractive keratectomy.

OBJECTIVE: We evaluated the clinical effects of blowing nitrogen gas over the cornea during photorefractive keratectomy. METHODS: We retrospectively compared clinical outcomes of 32 patients (37 eyes), divided into two groups who had photorefractive keratectomy with nitrogen gas blowing across the cornea (n = 19) and without nitrogen gas (n = 18). All photorefractive keratectomies were performed between April 1991 and August 1992. Ablation zone diameters were 5.0 or 5.5 mm. The average attempted correction was -3.47 +/- 1.76 diopters (D) in the nitrogen gas group, and -3.48 +/- 1.25 D in the non-nitrogen gas group. RESULTS: The nitrogen gas group achieved more accurate corrections than the non-nitrogen gas group, but had a significantly greater amount of corneal haze at all postoperative examinations. Corneal haze was most evident at 1 month and gradually diminished therafter in both groups. At 6 months, videokeratography revealed a central island in 2 eyes (11.1%) of the non-nitrogen gas group. Because of undercorrection (2 eyes) or central island (1 eye), 3 out of 18 eyes in the non-nitrogen gas group were reablated 6 months later. CONCLUSIONS: The non-nitrogen gas group had more undercorrections and a higher frequency rate of central steep islands, but nitrogen gas blowing caused a greater amount of corneal haze.

Administration, Topical↗

[Comparison of 133Xe gas dynamic SPECT and thin-section CT in patients with pulmonary emphysema].

PURPOSE: We assessed 133Xe gas dynamic single photon emission computed tomography (SPECT) by comparing washout axial images with thin-section CT (TSCT) in patients with pulmonary emphysema. METHODS: Twenty-three patients were studied. All patients were diagnosed as having pulmonary emphysema on the basis of TSCT. We compared TSCT of upper, middle and lower lung fields with 133Xe gas dynamic SPECT axial images at the corresponding levels during the 3 to 4 minutes of washout phase. If the degree of 133Xe gas retention or TSCT finding of ventral and dorsal parts was not the same, the images were divided into two parts. RESULTS: A total of 174 lesions in 23 cases were examined, but 3 lesions having no retention of 133Xe gas at equilibrium phase were excluded. The results showed that: there were 37 lesions (21.6%) with equivalent severity on both images; there were 42 lesions (24.5%) with more severity on 133Xe gas dynamic SPECT than on TSCT; and there were 92 lesions (53.8%) with more severity on TSCT than on 133Xe gas dynamic SPECT. The severity on 133Xe gas dynamic SPECT and TSCT was not always compatible. One of the reasons for the variable 133Xe gas retention even when the lesion had the same severity on TSCT, may be bronchial stricture which cannot be seen on TSCT. CONCLUSION: By comparison of axial images of 133Xe gas dynamic SPECT with CT images, we could recognize the areas of 133Xe gas retention in detail. Results suggest that 133Xe gas dynamic SPECT can be useful to identify ventilation impairment in pulmonary emphysema.

Aged↗