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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Graefe's archive for clinical and experimental ophthalmology 236 (1998), S. 420-425 
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  · Background: Striving for low to ultra-low postoperative intraocular pressure (IOP) through filtering surgery usually increases the incidence of prolonged hypotony. Early postoperative prognostic indicators for IOP control to lower normal level and prolonged hypotony in trabeculectomy with mitomycin C were examined to determine conditions required to obtain an optimum balance between them. · Methods: Records of initial trabeculectomy with mitomycin C (0.4 mg/ml, 3 min) in 59 consecutively operated Japanese patients with primary open-angle glaucoma who had used multiple medications before operation were retrospectively analyzed. IOP control to lower normal level was defined as having failed if IOP could not be maintained below 15 mm Hg without medication. Prolonged hypotony was defined as postoperative IOP below 5 mm Hg for more than 2 months, excluding the first month. The Cox proportional harzards model was applied to identify early postoperative factors contributing to the two surgical outcomes. · Results: Among the factors studied, only the mean IOP on postoperative days 9–14 was significantly correlated with the surgical outcome. A receiver operating characteristic plot suggested that mean IOP of 8 mm Hg in this period would give an optimum balance between the two. · Conclusion: IOP of 8 mm Hg 9–14 days after surgery may be advisable in patients with preoperative multiple medications in whom IOP control to lower normal level is attempted with mitomycin C trabeculectomy. Knowledge of this may helpful in deciding when laser lysis of sutures is indicated.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-198X
    Keywords: Key words Nutcracker syndrome ; Orthostatic symptoms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We describe four adolescents with the nutcracker syndrome. In three patients, the nutcracker syndrome was detected through mass urinary screening; the other patient was diagnosed after a sudden onset of dark urine. All patients underwent magnetic resonance angiography (MRA) for diagnosis of the nutcracker syndrome, which revealed dilatation of the left renal vein ranging between 7.4 and 13 mm at the hilar portion. A renal biopsy, perfomed in three patients, showed no remarkable abnormalities in the glomerulus or tubulointerstitial tissue. The patients complained of physical discomfort, including headache, abdominal pain, fainting, and tachycardia mimicking clinical symptoms of an orthostatic disturbance. However, no chronic systemic diseases were detected in any of the patients after repeated laboratory examinations. An orthostatic disturbance preceded diagnosis in three patients. This report indicates that the nutcracker syndrome may cause serious physical ailments that clinically mimick an orthostatic disturbance. It may be important to identify the nutcracker syndrome among children who manifest non-specific physical complaints. MRA could be a safe and reliable method for diagnosing the nutcracker syndrome.
    Type of Medium: Electronic Resource
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