bluuebunny/crossref_metadata_2025 huggingface dataset:
Erbiumr:YAG Laser Sclerectomy With a Sapphire Optical Fiber
Authors: McHam M Lisa , Eisenberg Dan L , Schuman Joel S , Wang Nan
Published: April 2021

* BACKGROUND AND OBJECTIVE: Laser sclerectomy may offer advantages to conventional glaucoma filtering surgery by minimizing conjunctival manipulation and subsequent subconjunctival scarring and by providing easier access to difficult locations. It has been theorized that minimizing collateral thermal damage may enhance the success rate and reduce complications associated with laser sclerectomy. The thermal damage induced by the pulsed erbium:yttrium aluminum garnet (EnYAG) laser is notably less than that of other laser modalities, including neodymium:YAG (1.06 pm), ErYSGG (2.79 urn), holmiumYAG (2.10 pm), and holmiumYSGG (2.10 pm). A major obstacle to the clinical use of the ErYAG laser has been the lack of an efficient and reliable delivery system. The single-crystal sapphire optical fiber has an acceptable attenuation rate and favorable characteristics for delivery of the Er: YAG wavelength in a clinical setting.

* MATERIALS AND METHODS: An ErYAG laser (2.94 pm) focused into a 300-pm, single-crystal sapphire fiber was used to create ab-externo sclerectomies with varying energy levels and pulse rates in each eye of six anesthetized rabbits and six human cadaver eyes. Specimens then underwent histopathologic analysis and determination of the thermal damage zone.

* RESULTS: For the rabbit sclerectomies, there was a significant positive correlation between energy per pulse and the diameter of the thermal damage zone, which averaged 22.0 ± 12.7 urn for all energy levels. For the human sclerectomies, a positive correlation existed between the total energy delivered (mj /pulse X total pulses) and the thermal damage zone, with the mean thermal damage zone being 25.0 ± 9.0 urn.

* CONCLUSION: The ErYAG laser with a sapphire optical fiber delivery system is an effective means of creating ab-externo sclerectomies with minimal thermal damage.

[Ophthalmic Surg Lasers 1997;28:55-58. J
Endophthalmitis Caused by Serratia marcescens
Authors: Cohen Steven M , Flynn Harry W , Miller Darlene
Published: April 2021

* BACKGROUND AND OBJECTIVE: To describe the clinical features and treatment outcomes of 10 patients with culture-proven Serratia marcescens endophthalmitis.

* PATIENTS AND METHODS: Records from the microbiology laboratory for the period from January 1980 through June 1993 were reviewed. Ten patients were identified who had positive anterior chamber or vitreous cultures and clinical signs of endophthalmitis. The medical records for these 10 patients were reviewed, and the patients were contacted for reexamination when possible.

* RESULTS: All 10 cases of 5. marcescens endophthalmitis occurred after ocular surgery. Eight eyes received intraocular antibiotics and 2 eyes were primarily enucleated or eviscerated. All organisms were sensitive to aminoglycosides and to ceftazidime. Repeat vitreous cultures were positive in 5 cases despite appropriate initial therapy with intravitreal and intravenous antibiotics. Final visual acuity was 20/400 or better in 4 of 10 eyes. A total of 4 eyes were enucleated or eviscerated at final follow-up. Eyes with light perception or better visual acuity had a mean follow-up of 23 months.

* CONCLUSION: S. marcescens can cause persistent endophthalmitis despite appropriate intravitreal and systemic antibiotic therapy. Eyes with S. marcescens endophthalmitis have a poor visual prognosis.

[Ophthalmic Surg Lasers 1997;28:195-200.]
Corneal Topography After Selective Suture Removal for Astigmatism Following Keratoplasty
Authors: Goren Matthew B , Dana Mohamad-Reza , Rapuano Christopher J , Gomes Jose A P , Cohen Elisabeth J , Laibson Peter R
Published: April 2021

* BACKGROUND AND OBJECTIVE: The authors sought to determine whether the immediate corneal topographic changes induced by selective suture removal for astigmatism after keratoplasty were stable over time.

* PATIENTS AND METHODS: Computerized videokeratoscopic images were obtained prior to and immediately following suture removal in 14 patients, and then again at the next postoperative visit 4 to 6 weeks later. These images were analyzed and statistically compared for central corneal power and vector of the central 3-mm corneal astigmatism.

* RESULTS: Most of the topographic changes induced by suture removal occurred immediately. However, continued shifting in corneal curvature did take place over the subsequent 4 to 6 weeks. Unpredictable shirts were more pronounced in patients whose surgery had been performed more than 20 months prior to suture removal.

* CONCLUSION: Computerized videokeratoscopy graphically elucidates continued shifts in corneal topography following the removal of sutures for the control of astigmatism after keratoplasty.

[Ophthalmic Surg Lasers 1997;28:208-214.]
Internal Sclerostomy With a Mechanical Trephine Versus the Neodymium:YAG Laser in Dogs
Authors: Peiffer R L , Nobles R D , Carter J , Pandya A D , Osborne C , Freedman S
Published: April 2021

* BACKGROUND AND OBJECTIVES: To experimentally compare and contrast the internal sclerostomy produced using a mechanical trephine with that made by an Nd:YAG laser, and to evaluate the healing patterns, efficacy, and technical advantages of each method.

* MATERIALS AND METHODS: Four healthy dogs with normal eyes were used in this study. The left eye of each dog had an internal sclerostomy performed with an automated mechanical trephine. The right eye of each dog had an internal sclerostomy performed with an Nd:YAG laser. Postoperatively, the intraocular pressure of each eye was measured at regular intervals. The dogs were euthanized successively at 1, 2, 3, and 4 weeks postoperatively, and the morphology of the surgical sites was studied.

* RESULTS: The Nd:YAG laser was easier to manipulate and technically less demanding than the mechanical trephine. However, the Nd:YAG laser induced more prominent corneal edema and conjunctival hyperemia compared with the automated trephine. Morphology of the tissue response showed tissue necrosis and greater inflammation with the Nd:YAG laser than with the automated trephine.

* CONCLUSIONS: These two techniques demonstrate differences in technical demands and tissue response. Both are characterized by minimal reactive fibrosis of the episcleral and Tenon's capsule fibroblast.

[Ophthalmic Surg Lasers 1997;28:223-230.]
The In Vivo Effects of a Prototype Diode Laser Coagulator/Vaporizing Endoprobe Used to Perform Retinectomy and Retinotomy in Rabbits
Authors: Hoggatt Judy S , Pulido Jose S , Nash Robert W , Simons Kenneth B , Han Dennis P
Published: April 2021

* BACKGROUND AND OBJECTIVE: A pilot study was conducted to evaluate the use of a prototype intraocular carbon-coated diode laser probe for performing single-instrument internal retinotomy and retinectomy.

* MATERIALS AND METHODS: A 20-gauge endolaser probe was used to perform retinotomies on 10 anesthetized rabbits. Two protocols were examined: one using low power and long duration, and one using high power and short duration. Retinotomies were performed on attached and experimentally detached retinas.

* RESULTS: Retinotomies were performed in all eyes using both protocols. The edges had photocoagulative effects in all cases. The eyes treated with the longer duration, lower power protocol had scleral damage, whereas the eyes treated with shorter duration, higher power did not.

* CONCLUSION: Although the diode laser coagulator/cutter may be used for retinotomies, it should be studied further.

[Ophthalmic Surg Lasers 1997;28:231-235-]
Combined Peribulbar and Retrobulbar Block Anesthesia and Antibiotic-Steroid Injection: A Simple Method to Prevent Retrobulbar Hemorrhage, Globe Perforation, or Infection
Authors: Guard Louis J , Donaldson Kenley
Published: April 2021

Abstract. The complications of retrobulbar and peribulbar analgesia/akinesia can be prevented by exploration of the peribulbar space with the surgeons finger and continuous injection as the needle is passed slowly through the periorbital space and into the muscle cone. [Ophthalmic Surg Lasers 1997;28:251-254.]
The Intraocular Penetration of Dexamethasone After Photorefractive Keratectomy
Authors: McDermott Mark L , Vale Steven , Tayfour Fouad , Cowden John W
Published: April 2021

* BACKGROUND AND OBJECTIVE: To deter mine the effect of photorefractive keratectomy (PRK) on intraocular steroid penetration.

* MATERIALS AND METHODS: To assess steroid penetration after PRK, four rabbits underwent unilateral myopic 9.90-D PRK procedures. The other eye was left undisturbed as a control. One week later both eyes received hourly doses of radiolabeled topical dexamethasone.

* RESULTS: No significant difference in corneal tissue [(mean ± 1 SD) PRK 4.8 ± 1.1 pg/g, control 5.2 ± 1.2 pg/g] or aqueous humor concentration [(mean ± 1 SD) PRK 0.8 ±0.12 pg/ml, control 0.9 ± 0.05 pg/ml] of dexamethasone was seen.

* CONCLUSIONS: Dexamethasone penetration in eyes 1 week following PRK is similar to that of the unablated cornea.

[Ophthalmic Surg Lasers 1998;29:839-841.]
The Effect of Adjustable Suture Techniques on Scleral Resistance
Authors: Keech Ronald V
Published: April 2021

* BACKGROUND AND OBJECTIVE: The effect of adjustable suture strabismus surgery techniques on the ease of the postoperative adjustment has not been determined. An in vitro animal model was developed to compare several intraoperative variables with the ability to adjust the sutures.

* MATERIALS AND METHODS: The amount of force required to advance and recess the suture was measured using different sutures, suture coatings, needles, and scleral tunnel techniques.

* RESULTS: Scleral tunnels placed at an angle to the muscle insertion caused significantly greater scleral resistance as compared with tunnels placed perpendicular to the insertion. Although differences were noted in the scleral resistance with different needles, suture coatings, and suture materials, there was a considerable overlap of the effect.

* CONCLUSIONS: Scleral tunnels placed perpendicular to the muscle insertion and parallel to the plane of action of the muscle offer the best technique for minimizing scleral resistance. Other less important factors include shorter scleral tunnels, larger needles, and special suture coatings.

[Ophthalmic Surg Lasers 1998;29:842-848.]
Treatment of Bleb Hypotony After Phacoemulsification With Autologous Blood
Authors: McCoy Renée Cane , Burney Edward N
Published: April 2021

Abstract. Hypotony from an inadvertent filtration bleb developed in the eye of a 66-year-old woman 1 year after phacoemulsification cataract surgery. The hypotony was treated with an autologous blood injection over the previous phacoemulsification incision. This technique successfully treated the hypotony without additional ocular surgery. The authors report an effective alternative treatment for hypotony induced by an inadvertent filtration bleb. [Ophthalmic Surg Lasers 1998;29:849-851.]
Successful Medical Management of Orbital Abscess in a Patient With Sickle Cell Anemia
Authors: Nath Jayany , Jin David K , Rahman Riaz , Ballas Samir K , Batuman Olcay A
Published: April 2021

Abstract. The authors describe a patient with sickle cell anemia who had an orbital abscess at the site of a bone infarct during hospitalization for a painful crisis. Because the patient was in close medical observation, the orbital abscess was diagnosed within 48 hours of the onset of symptoms. The patient was treated with a 2-week course of intravenous antibiotics. This resulted in complete resolution of the abscess, as evidenced by clinical improvement and findings on computerized axial tomography scanning. The authors conclude that a heightened suspicion of orbital abscess in sickle cell patients with ocular symptoms will allow the diagnosis of an orbital abscess that can then be cured with antibiotic treatment but without orbital surgery. [Ophthalmic Surg Lasers 1998;29:860-863.]
Corneal Topography After Cataract Surgery Using a Clear Corneal Incision Closed With One Radial Suture
Authors: Black Eva H , Cohen Kenneth L , Tripoli Nancy K
Published: April 2021

* BACKGROUND AND OBJECTIVE: To deter mine whether corneal topography and visual recovery are affected by suturing a temporal, clear corneal incision for cataract surgery.

* PATIENTS AND METHODS: Forty-one consecutive phacoemulsification patients (39 eyes) had a 3.2mm incision sutured with one 10-0 nylon, radial suture removed after 1 postoperative week. Visual acuity (VA) and corneal topography, including best fit sphere (BFS), best fit cylinder (BFC), principle meridian, topographic irregularity (TI), and vector-corrected astigmatism (VCA), were measured preoperatively and 1 day, 1 week, and 1 month postoperatively. Twotailed t tests and Pearson correlations were calculated.

* RESULTS: From the preoperative measurement to 1 week postoperatively, VA improved, BFS (P = .005) and TI (P = .033) increased, and VCA shifted withthe-rule. From 1 week to 1 month postoperatively, BFS (P= .012) and TI (P= .002) decreased. BFC and its direction did not change. Almost all measures were significantly correlated.

* CONCLUSION: The benefits of sutureless surgery on corneal topography and visual recovery are not degraded by using a suture to prevent wound leakage.

[Ophthalmic Surg Lasers 1998;29:896-903.]
Anticoagulation Therapy and Ocular Surgery
Authors: Saitoh Ayumi Kondo , Saitoh Akira , Taniguchi Hiroyasu , Amemiya Tsugio
Published: April 2021

* BACKGROUND AND OBJECTIVE: It is not rare for patients receiving anticoagulant therapy to undergo ocular surgery; however, there are no clear guidelines with reference to the operative management of the eye. This study examines the complications in patients receiving anticoagulant therapy who undergo ocular operations and suggests a management regimen for these patients.

* PATIENTS AND METHODS: The authors retro spectively analyzed 52 patients receiving anticoagulant therapy who underwent ocular surgery between 1 993 and 1995. Data included sex, age, reason for anticoagulant therapy, operative procedure, complication rate, and length of time anticoagulant therapy was stopped or reduced prior to surgery. To show the base-line complication rate at their institution, data of patients not receiving anticoagulation therapy were added.

* RESULTS: Ticlopidine hydrochloride, an antiplatelet drug, was administered to 24 patients. Warfarin sodium was administered to 8 patients, heparin was administered to 8 patients, and other anticoagulants were administered to 20 patients. There were no significant differences in complications between the groups that stopped or reduced anticoagulant therapy and those that did not, but speech disturbance due to thrombotic complication occurred in 1 of 10 patients in whom ticlopidine hydrochloride was stopped or reduced. Hemorrhagic complications occurred in 50% of those who continued ticlopidine hydrochloride, but in none of those who discontinued it (P = .019). There was a significant difference in hemorrhagic complications after cataract surgery between the phacoemulsification, aspiration, and intraocular lens implantation (PEA+ IOL) and the planned extracapsular cataract extraction and intraocular lens implantation (PECCE+IOL) groups that continued the drug (P= .0011). No patients showed visual acuity reduction due to hemorrhagic complications.

* CONCLUSIONS: To avoid life-threatening systemic complications, one need not always stop anticoagulant therapy before performing only cataract surgery. Cataract surgery in patients receiving ticlopidine hydrochloride should be performed with PEA+IOL via a small sclerocorneal or a corneal incision. In cataract surgery for patients receiving anticoagulant therapy, hemorrhagic complications are more frequent than in patients not receiving anticoagulant therapy.

[Ophthalmic Surg Lasers 1998;29:909-915.]
The Use of Dextran After Keratoplasty for Visualizing the Vitreous Cavity
Authors: Quiroz-Mercado Hugo , Orman Elizabeth Salinas-Van , Morales-Cantón Virgilio , de Regil-Romero Mateo , Cuevas-Cancino Diego
Published: April 2021

* BACKGROUND AND OBJECTIVE: Corneal edema during penetrating keratoplasty (PK) precludes the visualization of the fundus required to perform vitreoretinal surgery. In this study, the clearing of the cornea and fundus visualization with dextran 40 following PK was evaluated.

* PATIENTS AND METHODS: Topical dextran 40 was used in 12 eyes that underwent uncomplicated PK (phase 1) and in 5 eyes that underwent combined PK with vitreoretinal surgery (phase 2).

* RESULTS: Clearing of the cornea and visualization of the fundus were observed in all eyes after dextran had been instilled for a mean of 4 and 5 minutes in eyes for phase 1 and 2, respectively. Vitreoretinal surgery could successfully be performed after PK in all eyes of phase 2.

* CONCLUSION: Topical use of dextran 40 following PK produces enough clearing of the cornea to enable visualization of the fundus for further vitreoretinal procedures after the graft has been sutured.

[Ophthalmic Surg Lasers 1998;29:980-984.]
Prevention of Posterior Capsule Opacification With the CO2 Laser
Authors: Michaeli-Cohen Adi , Belkin Michael , GoIdring Alon , Rosner Mordechai , Assia Ehud I
Published: April 2021

* BACKGROUND AND OBJECTIVE: Posterior capsule opacification (PCO) is a common complication after cataract extraction, despite the modern surgical techniques and lenses being used for this procedure. Its prevention challenged many investigators, because the current treatment of choice, capsulotomy with Nd:YAG laser, is associated with sight-threatening complications. In the present study, the authors investigated two approaches of preventing PCO using the CO2 laser.

* MATERIALS AND METHODS: A 15-W CO2 laser with a 17- or 18-gauge hollow probe was used on 20 sheep eyes and 14 rabbit eyes. Lens extraction was done by phacoemulsification. In the equatorial treatment study, the anterior chamber was filled with either air or a viscoelastic substance, and laser burns were applied to the equator of the lens capsule and to the peripheral anterior capsule to destroy the epithelial cells. In the capsulotomy study, a primary posterior capsulotomy was created by delivering 1 to 3 laser shots to the capsule behind an implanted intraocular lens (IOL).

* RESULTS: The CO2 laser was satisfactory in sheep eyes after filling the anterior chamber with air. In rabbit eyes, however, it was technically impractical to work with air. Using a viscoelastic material to maintain the anterior chamber, the hollow probe of the CO2 laser becomes plugged up and therefore is unable to affect the ocular tissue. However, by combining viscoelastic and air pumping, both the destruction of the lens epithelial cells and the creation of a central posterior opening behind a capsular-fixated IOL was repeatedly achieved.

* CONCLUSION: Using the CO2 laser for destruction of lens epithelial cells and the creation of controlled posterior capsulotomy is feasible and practical. A different design of the probe (closed gauge) is required to enable it to operate clinically in a fluid or viscoelastic environment.

[Ophthalmic Surg Lasers 1998;29:985-990.]
Proliferative Diabetic Retinopathy With a Proliferative Membrane That Spread Anteriorly From the Optic Disc
Authors: Ikeda Tsunehiko , Kurihara Mana , Mori Kazuhiko
Published: April 2021

Abstract. The authors report a case of proliferative diabetic retinopathy in which the proliferating membrane spread from the optic disc to the anterior of the eyeball, and did not appear to involve the posterior precorneal vitreous pocket. [Ophthalmic Surg Lasers 1998;29:996-997.]
Pars Plana Vitrectomy for Macular Holes Combined with Cataract Extraction and Lens Implantation
Authors: Kotecha Amy V , Sinclair Stephen H , Gupta Amit K , Tipperman Richard
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of cataract extraction and lens implantation at the time of pars plana vitrectomy (PPV) for macular hole (MH) repair.

* MATERIALS AND METHODS: A retrospective study was conducted of 21 eyes that had PPV for MH combined with cataract extraction and lens implantation. Visual acuities (VA) were followed and complications noted.

* RESULTS: Of 21 eyes, successful anatomic closure was achieved in 16 (76.2%), and 13 (62.0%) improved in VA by at least 2 Snellen lines. Few complications occurted.

* CONCLUSION: Procedures that combine PPV for MH with cataract extraction and lens implantation decrease the need for future ophthalmic surgery, allow for clearer intraoperative visualization, and facilitate visual rehabilitation. This combined procedure is a relatively safe and effective alternative to separate pars plana and cataract surgeries.

[Ophthalmic Surg Lasers 2000;31:387-393]
Epithelial Folds Following Slippage of LASIK Flap
Authors: Carlson Keith H , Carpel Emmett F
Published: April 2021

Abstract. We present a case of a slipped corneal flap after laser-assisted in-situ keratomileusis, LASIK. A 22-year-old, female with myopia and a refractive error of '5.50 D sph OU had an uneventful LASIK performed on her left eye with a Chiron Automated Corneal Shaper® (ACS) and a VISX-Star Excimer® laser using a nasal hinged flap. On the first postoperative day, slit lamp examination revealed 4.0 mm slippage of the corneal flap. The flap was rolled and folded on itself within the inferior cul-de-sac. With the aid of the operating microscope, the flap was repositioned on the stromal bed. Immediately following the repositioning, many folds were still visible despite centering the flap on the stromal bed and performing stretching maneuvers. Detailed examination showed the folds to be of edematous epithelial origin. The underlying stromal bed was flat. Within days following repositioning, the folds had disappeared and the flap assumed the typical postoperative LASIK appearance. The final uncorrected visual acuity returned to 20/20. [Ophthalmic Surg Lasers 2000;31:435-437]
Repairing the Hole in Hydroxyapatite Orbital Implants Following Peg Removal
Authors: Jordan David R
Published: April 2021

Abstract. Pegging hydroxyapatite implants may lead to improved prosthetic eye movement but may also be associated with complications that may occasionally require peg removal. Removing the peg and leaving the peg hole to spontaneously granulate in, is one technique to deal with the remaining implant hole. The author describes a simple technique to fill the peg hole that provides a smooth implant-conjunctival-prosthesis intetface and may potentially allow repegging. [Ophthalmic Surg Lasers 2000;31:438-440]
Lateral Rectus Split in the Management of Duane's Retraction Syndrome
Authors: Das Jaya Chandra , Chaudhuri Zia , Bhomaj Sharad , Sharma Pankaj
Published: April 2021

Abstract. This case reports Type I Duane's Retraction Syndrome with marked upshoot of the globe in adduction. An 18-year-old patient presented with complaints of not being able to move his left eye outwards since childhood. A 'Y' split of the lateral rectus muscle was performed in the affected eye. There was marked cosmetic and functional improvement in the patient which was stable after 6 months of follow-up. Y splitting of the lateral rectus muscle is a simple technique that can be used effectively in the treatment of marked upshoot or downshoot in Duane's Retraction Syndrome. [Ophthalmic Surg Lasers 2000;31:499-501]
Erbium:YAG Laser Deep Sclerectomy: An Alternative Approach to Glaucoma Surgery
Authors: Pallikaris Ioannis G , Kozobolis Vassilios P , Christodoulakis Emmanouil V
Published: April 2021

* BACKGROUND AND OBJECTIVES: To study and evaluate, prospectiveiy, the effectiveness and the safety of deep sclerectomy when it is performed with the assistance of the erbium:YAG laser in eyes with primary open-angle glaucoma.

* PATIENTS AND METHODS: Forty eyes of 40 patients with primary open-angle glaucoma or pseudoexfoliative glaucoma were enrolled consecutively to undergo laser deep sclerectomy. Mitomycin C (0.2 mg/mL for 2.5 minutes) was also used before the superficial scierai flap formation. The follow-up was 24 months for all patients.

* RESULTS: The intraocular pressure was significantly decreased by 9.15 mm Hg or 35.1% (from 26.05 ± 2.55 to 16.9 ± 3.45 mm Hg) at the end of the follow-up period. The complete and qualified success rates at the end of the follow-up period were 37.5% and 62.5%, respectively. Mild complications such as choroidal detachment, hyphema, and leakage were observed.

* CONCLUSIONS: The use of the erbium:YAG laser for performing a deep sclerectomy procedure seems to be a safe and relatively effective alternative to the conventional surgical procedure. Further studies and longer follow-up are necessary for the evaluation of the efficacy of this technique.

[Ophthalmic Surg Lasers Imaging 2003;34:375-380.]
Giant Nodular Posterior Scleritis Simulating Choroidal Melanoma and Birdshot Retinochoroidopathy
Authors: Arevalo J Fernando , Shields Carol L , Shields Jerry A
Published: April 2021

Abstract. A case of nodular posterior scleritis simulating both a choroidal tumor and birdshot chorioretinopathy is described. Fluorescein angiography, indocyanine green angiography, and ultrasound were performed. Results of laboratory tests were normal, including HLA-A29, erythrocyte sedimentation rate, rheumatoid factor, and antinuclear antibodies. A chest x-ray was normal. A diagnosis of nodular posterior scleritis was made and the minimally symptomatic patient without ocular pain was observed unless symptoms progressed. In this case, certain clinical features led to the proper diagnosis. [Ophthalmic Surg Lasers Imaging 2003;34:403-405.]
Argon Laser Photocoagulation for the Treatment of Idiopathic, Bilateral, Recurrent, Diffuse Retinal Arterial Aneurysms
Authors: Kwok Alvin K H , Lai Timothy Y Y , Wu Raymond M
Published: April 2021

Abstract. Spontaneous resolution of retinal arterial aneurysms may occur, but recurrences are uncommon. A case of idiopathic, bilateral, recurrent, diffuse retinal arterial aneurysms treated with direct laser photocoagulation is described. A 30-year-old woman with a history of physiologic menopause was found to have bilateral, diffuse, multiple retinal arterial aneurysms with massive subretinal exudates and intraretinal hemorrhages. Fluorescein angiography demonstrated multiple retinal arterial aneurysms with leakage. Direct argon laser photocoagulation successfully closed the aneurysms. During 6 years of follow-up, the aneurysms reoccurred twice, coinciding with a postpartum period. Recurrences were successfully treated with repeated laser photocoagulation with the aneurysms closed off. Hormonal imbalance may play a role in this condition. Recurrent retinal arterial aneurysms can be managed by direct laser photocoagulation. [Ophthalmic Surg Lasers Imaging 2003;34:437-439.]
Three types of weak pullback attractors for lattice pseudo-parabolic equations driven by locally Lipschitz noise
Authors: She Lianbing , Liu Nan , Li Xin , Wang Renhai
Published: April 2021

The global well-posedness and long-time mean random dynamics are studied for a high-dimensional non-autonomous stochastic nonlinear lattice pseudo-parabolic equation with locally Lipschitz drift and diffusion terms. The existence and uniqueness of three different types of weak pullback mean random attractors as well as their relations are established for the mean random dynamical systems generated by the solution operators. This is the first paper to study the well-posedness and dynamics of the stochastic lattice pseudo-parabolic equation even when the nonlinear noise reduces to the linear one.
Travailler à l’université. La définition étudiante du niveau et de la direction des efforts à fournir
Authors: David Marie
Published: April 2021

Cet article contribue à la sociologie des savoirs dans l’enseignement supérieur en s’intéressant à la perspective des étudiants, c’est-à-dire à la manière dont ils construisent un point de vue collectif sur le travail qu’ils ont à faire. L'auteure s’appuie sur une enquête portant sur des étudiants de première année de licence, en sociologie, chimie et physique. Elle analyse l’apprentissage des savoirs comme un cas particulier de situation collective de travail, qui peut être étudié avec les outils interactionnistes de sociologie du travail. Il s’agit ici de comprendre comment les étudiants résolvent certains des problèmes qui se posent à eux, comme la gestion de la quantité de travail à faire et la hiérarchisation des tâches universitaires.
L’hyperféminisation des chanteuses japonaises : shôjo kashu et aidoru
Authors: Chûjô Chiharu , Wartelle-Sakamoto Clara
Published: April 2021

Le phénomène des aidoru, ces jeunes vedettes féminines à la fois chanteuses, danseuses et actrices, souvent issues de groupes de pop japonaise fabriqués de toutes pièces par une puissante industrie musicale, s’est grandement développé à la fin des années 1960. La forte médiatisation de ces jeunes artistes les soumet à des exigences importantes, en particulier physiques et morales : elles doivent adopter des tenues et des comportements pour satisfaire et fidéliser leurs fans. Mais leur représentation d’adolescentes modèles aux caractéristiques physiques et aux attitudes hyperféminisées peut troubler, tant elle joue à la fois sur un mode de séduction et d’allusions sexuelles, et sur une apparence volontairement enfantine et immature. Leur carrière et leurs salaires étant déterminés par leur notoriété, cette dernière pouvant rapidement être mise à mal par un scandale touchant à leur vie privée, les aidoru évoluent dans une relation avec leur public qui s’apparente à un dispositif de voyeurisme et de fan service.Cette figure de la chanteuse ou actrice adolescente à succès s’observe déjà avant-guerre, avec le phénomène des shôjo kashu (« fillettes chanteuses »). Elles incarnent alors la pureté et l’innocence de l’enfance et sont bien souvent cantonnées à des répertoires et des rôles qui valorisent ces qualités. Or, dans les années 1950, des artistes comme Misora Hibari semblent s’éloigner peu à peu de cette vision et offrir une image jouant sur une ambiguïté séductrice s’incarnant dans un corps d’enfant. Dans cet article, nous reviendrons sur les contextes historiques et culturels dans lesquels ont évolué shôjo kashu et aidoru, afin de mieux comprendre ce qui constitue un phénomène majeur dans l’industrie musicale japonaise.
La Petite Mort: Techniques of Orgasm in Electronic Dance Music
Authors: Young Toby
Published: April 2021

Portrayals of sexualized narratives are rife in ethnographic accounts of Electronic Dance Music (EDM), where the visceral musical and haptic experiences of dancing to club music are intertwined in a tantalizing symbiosis. This is music that is habitually understood through erotic semiosis: protracted build ups of stimulation and intensity, layer upon layer of musical repetition being added in service of arousal, and a teasing denial of harmonic and sonic resolution are expanded and amplified, until there is a final fulfilment granted by the DJ at the moment of the “drop”. Bringing together musicological discussions of climax with socio-psychological and neurological research on the orgasm, this article explores the manifold ways in which technologies of arousal in dance music mediate the sexual space of the dancefloor and consider how metaphors of pleasure and fulfilment are actualised in EDM in ways which destabilise the prevalent body of heteronormative, male-focussed narratives around stimulation and arousal.
L’agentivité d’une île : au cœur des Stigmatisés (1918) de Franz Schreker
Authors: Flamion Aurore
Published: April 2021

Créé en 1918, l’opéra Die Gezeichneten (« Les Stigmatisés ») de Franz Schreker a suscité de nombreux discours fustigeant l’omniprésence d’une sexualité débridée et délétère, s’attachant indistinctement au sujet, à la musique ou au compositeur lui-même. L’œuvre met en scène la tragédie d’un jeune noble, laid, qui ayant cru en la rédemption par l’amour, sombre dans la folie après avoir cédé à la ville de Gênes une île appelée « Élysée » et dédiée aux plaisirs charnels.L’ambition de cet article est de redonner une place au matériau opératique lui-même : paradoxalement réduite à l’anecdotique dans sa réception contemporaine, l’œuvre déploie pourtant des mécanismes puissants qui, illustrés par la mise en abyme de la venue des Génois sur l’île, agissent avec force sur les spectateurs. Il s’agit de mettre au jour en deux temps les moyens déployés par l’opéra pour imposer au spectateur intra-diégétique – et par extension, au public de l’œuvre – une stase qui se révèle être profondément érotique. La première partie, consacrée à l’esthétique du tableau vivant que convoque le IIIe acte, analyse les différentes modalités de la subjugation visuelle à laquelle est soumis le peuple génois. La deuxième partie poursuit cette analyse de la stase érotique sur le plan proprement musical, en étudiant les textures orchestrales caractéristiques de l’esthétique de Schreker.
« L’orchestre dans les sons brave l’honnêteté... » : Le rôle de l’élément érotique dans l’œuvre de Massenet.
Authors: Fauser Annegret
Published: April 2021

Esclarmonde, un opéra de Jules Massenet créé à Paris en 1889 pendant l’Exposition Universelle, est un bon exemple de comment un livret basé sur des structures socialement conservatrices peut donner lieu à une expressivité musicalement progressive. Cet article propose une critique féministe de cet opéra, en se focalisant sur le rôle-titre et sur comment le livret et la partition articulent l’érotique et l’exotique. L’analyse part de la réception de l’opéra en 1889, en se penchant sur les lectures socio-politiques qui en sont faites, ainsi que sur les discussions de la capacité esthétique de la musique à produire une immédiateté sensuelle.
“The Orchestra, in its Sounds, Defies Virtue…”: The Role of the Erotic in the Works of Massenet.
Authors: Fauser Annegret
Published: April 2021

Massenet’s opera Esclarmonde, premiered in Paris during the 1889 Exposition Universelle, offers a particularly powerful case study for the ways in which a libretto articulating socially conservative structures meshes with, and enables, musically progressive expressivity. This essay analyses the opera from a perspective of feminist critique, centering on the title role and providing a close reading of both libretto and score as they play with the erotic and the exotic. The analysis is framed through the lens of the opera’s reception in 1889 by way of socio-political readings and of discussions of music’s aesthetic capacity for sensual immediacy.
Agriculture Biomaterial Industry in Romania
Authors: Bancescu Irina
Published: April 2021

Rural areas in Romania are underdeveloped, with the main economic activity being agriculture. Urban-rural income gap and poverty levels are indicative of an underdeveloped rural area. Urban-rural absolute income gap for average monthly income increased from 352 RON in 2007 to 663 RON in 2017. Moreover, the work poverty rate is higher in rural areas than in urban areas. Economic rural development can be achieved by improvements of the labour market and introduction of new value-added products. Agricultural and non-agricultural activities are dependent on each other for a successful rural development leading to poverty alleviation. An industry that combines the two types of economic activities is agriculture biomaterial industry. In this paper, the authos investigates the factors influencing rural poverty and analyses the current stage of the bioplastics market in Romania and its economic implications. Bioplastics industry can reduce urban-rural income gaps and poverty in rural areas.
Comprehensive Approach to Implement E-Government Backend in Jordan Using Service-Oriented Architecture
Authors: Qusef Abdallah , Ayasrah Abdallah , Shaout Adnan
Published: April 2021

This paper proposes a comprehensive approach to implement and deploy a backend middleware for e-government in Jordan using service-oriented architecture (SOA) and enterprise service bus (ESB). The proposed approach takes into consideration a full overview of needed e-services as well as all stakeholders communicating within e-government environment. The paper describes the high-level architecture of the proposed approach and then goes deeper to describe the internal implementation of the middleware and its layers. Finally, the paper addresses some deployment issues and proposes a deployment architecture to overcome these issues.
Spirituality and spiritual care in in the context of nursing education in South Africa
Authors: Chandramohan Sandhya , Bhagwan Raisuyah
Published: April 2021

Background: In order for nursing education to prepare nurses for holistic patient care, it is critical that educators become more aware of the religious and spiritual dimensions in patien tcare and be able to provide adequate knowledge and skills for nurses to offer spiritually-basedc are in an ethical way. Furthermore, spiritual care is an essential component in the nursing context, as nurses have to care for patients who may often turn to the spiritual dimension to cope and heal. These aspects are important issues to be considered in planning what should be taught as part of spiritual care.Objectives: This paper presents findings from a study on nursing practitioners’ views on the role of spiritual care in nursing practice and whether current nursing education has integrated this dimension into teaching.Method: A descriptive survey using a cross-sectional design with 385 nurses was conducted between December 2012 and February 2013. Participants were recruited through multistage random sampling. Data analysis was undertaken using SSPS 0.20.Results: All the participants (n = 385) concurred that spiritual care was a salient component of holistic patient care. They however stated that the primary barriers to providing spiritual care related to uncertainty on how to provide this type of care, and a lack of educational preparedness for this role.Conclusion: The study found that nurses were very accepting of the need for spiritual care as part of their nursing role but that nursing education had not paid adequate attention to integrating this dimension into the nursing curriculum.
Utility of GeneXpert Mycobacterium Tuberculosis/Rifampicin Assay in Smear-Negative Pulmonary Tuberculosis
Authors: Mohammadi Javeriya , Reddy Gummadi A. , Haran Alamelu
Published: April 2021

Background:

Tuberculosis (TB) remains one of the world's deadliest communicable diseases. An alarming rise in the incidence of Mycobacterium tuberculosis (MTB) has prompted the need for rapid diagnostic techniques. Despite low sensitivity in MTB detection, sputum microscopy remains the main diagnostic method, especially in resource-limited settings. Mycobacterial culture is the gold standard method for TB diagnosis; however, the use in clinical practice is limited due to longer time, biosafety requirements, and high cost. In December 2010, the World Health Organization (WHO) 1st endorsed the usage of Xpert MTB/rifampicin (RIF) assay. The WHO recommends that GeneXpert test could be used as a follow on test to microscopy, especially in smear-negative specimens.

Objectives:

To assess percentage of Tuberculosis cases and Multi Drug Resistant (MDR) case detection at diagnosis using Xpert MTB/RIF assay in smear-negative pulmonary cases.

Materials and Methodology:

Detailed relevant clinical history and examination were carried out for 105 pulmonary TB suspect patients. Sputum acid-fast bacilli smear two samples and human immunodeficiency virus status were checked under RNTCP; chest X-ray PA view was done. Smear-negative patients were subjected to bronchoscopy and bronchoalveolar lavage (BAL)/bronchial washing. BAL/Bronchial washing was tested for GeneXpert.

Interpretation and Conclusion:

MTB was detected in 21 (20%) samples out of 105 samples and RIF resistance was detected in 1 (1%) sample. Most common chest x-ray abnormalities were cavity (33.3%) and consolidation (33.3%). 8 cases (38.1%) among Gene xpert positives had past history of Tuberculosis. Comorbidities were found in 5 cases (23.8%) among Gene Xpert positives. The present study concludes that using standard clinical assessment for selection, five patients need to be tested to detect one case of smear-negative TB. Smear-negative patients could benefit from Xpert, particularly in areas where no culture is available.
Sepsis and Anticoagulant, is Amputation a Lifesaving Surgery?
Authors: Kumar Neeraj , Kumar Amarjeet , Kumar Anil , Kumar Sanjeev , Singh Veena
Published: April 2021

Patients with severe sepsis are associated with coagulation abnormalities ranging from minimal to major activation of coagulation system, which may lead to fulminant disseminated intravascular coagulation (DIC) and multiorgan failure. Lower extremity amputation is indicated to remove ischemic, infected, or necrotic tissue or locally unresectable tumor and, at times, may be lifesaving. Peripheral artery disease and diabetes are the leading causes of non-traumatic lower extremity amputation. Amputation of lower limb in patient of severe sepsis associated with coagulation abnormalities may be limb saving surgery but may not be lifesaving surgery as in our case patient died due to multiorgan failure.
An Update on Adult Immunization
Authors: Kamath Vasantha , Markanday Kushal , Nivea B
Published: April 2021

Childhood immunization is recommended and publicized globally, whereas the adult population, which comprises more than 60% of the total population, still suffers from vaccine-preventable diseases due to factors ranging from personal neglect to immunosenescence. This burden is vastly seen in developing nations like India where adults constitute a large chunk of economic productivity. This article highlights the current scenario and recommendations for adult immunization globally taking into account special conditions such as immunization in the geriatric population, pregnant women, and in travelers.
A Comparative Study of Platelet Indices in Stable Versus Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Authors: Archita R. , Ashok M. L.
Published: April 2021

Background and Objectives:

Chronic obstructive pulmonary disease (COPD) is a major global health problem. A strategy for prevention and early treatment of COPD exacerbations is essential to better address the disease. Hence, the study was undertaken to compare the various platelet indices in patients with acute exacerbation versus stable COPD and study the relationship of these indices with the severity of COPD exacerbation to aid in better patient management.

Methodology:

The study was conducted at the hospitals attached to Bangalore Medical College and Research Institute from November 2017 to May 2019, on patients with stable and acute exacerbation of COPD. Brief history with relevant investigations was performed. Platelet indices were compared between the two groups. The relationship between the platelet indices and the severity of acute exacerbation of COPD was also studied.

Results:

Among the platelet indices, there was a statistical difference in the mean values of mean platelet volume (MPV) and platelet distribution width (PDW) in the two groups. The MPV and PDW values were 8.85 fL and 7.91 fL and 15.94% and 17.14%, respectively, during the stable period and exacerbations of COPD, respectively. Furthermore, in our study, it was found that there was no significant association between the degree of hypoxia and the platelet indices.

Conclusion:

Among the various platelet indices, our study suggests that the MPV reduced and PDW increased in patients with acute exacerbation when compared to stable COPD. Furthermore, our study did not show any significant correlation between the platelet indices and the severity of COPD as determined by the degree of hypoxia.
Portal biliopathy in a Nigerian
Authors: Oluyemi Aderemi O. , Waghmare Sumedh K. , Kuti Raymond A.
Published: April 2021

Portal biliopathy (PB) was well delineated as a distinct clinical entity in the 1990s. Since then, science has much improved in diagnosing and managing this condition. Currently, magnetic resonance imaging and cholangiopancreatography have largely replaced endoscopic retrograde cholangiopancreatography as the most important tool in PB diagnosis. Our resource-limited environment has not allowed for optimal availability and uptake of this tool in general but when it is deployed, as in this index case, it can yield great and accurate dividend. This report is the first such scientific documentation of PB in a Nigerian adult. It seeks to show the striking radiological image appearances upon which diagnosis is based. We hope that the article will help increase the index of suspicion for such a rare diagnosis in our locality and that it will encourage the more widespread deployment of such essential and beneficial radiological tools in disease diagnosis.
Deprescribing Antidepressants in Older People ‐ Breaking Up Can Be Hard to Do
Authors: Mangin Dee , Siu Henry Y.H.
Published: April 2021

Every drug review for older people should consider which medicines to continue, but equally important, which medicines can be discontinued. As we age, the balance between potential benefits and potential risks of medications often shifts towards more harm. For example, antidepressants
are commonly prescribed in general, but in the older person, they carry specific potential harms. Further, there are data indicating that a substantial proportion of users have no evidence-based indications to continue antidepressants and could be candidates to try stopping treatment. We outline
first the imperatives and evidence for deprescribing antidepressants and then finally some practical approaches to deprescribing.
On the number of Galois orbits of newforms
Authors: Dieulefait Luis Victor , Pacetti Ariel , Tsaknias Panagiotis
Published: April 2021

Counting the number of Galois orbits of newforms in

S_k(\Gamma_0(N))

and giving some arithmetic sense to this number is an interesting open problem. The case

N=1

corresponds to Maeda's conjecture (still an open problem) and the expected number of orbits in this case is 1, for any

k \ge 16

. In this article we give local invariants of Galois orbits of newforms for general

N

and count their number. Using an existence result of newforms with prescribed local invariants we prove a lower bound for the number of non-CM Galois orbits of newforms for

\Gamma_0(N)

for large enough weight

k

(under some technical assumptions on

N

). Numerical evidence suggests that in most cases this lower bound is indeed an equality, thus we leave as a question the possibility that a generalization of Maeda's conjecture could follow from our work. We finish the paper with some natural generalizations of the problem and show some of the implications that a generalization of Maeda's conjecture has.
Synthesis, characterization and antimicrobial activity of Mn(II), Co(II) and Ni(II) complexes with schiff base derived from 4-chloroaniline and salicylaldehyde
Authors: Ibrahim A.K. , Yusuf B.A. , Sambo B.U.
Published: April 2021

Transition Metal Complexes of Mn(II),Co(II) and Ni(II) with Schiff base derived from 4- chloroaniline and Salicylaldehyde were synthesized and characterized by conductivity measurement, magnetic susceptibility, infrared spectra, metal-ligand ratio determination and solubility test. The Schiff base and its metal complexes were tested for antibacterial activity against Staphylococcus aureus and Escherichia coli and fungal activity against Aspergillus flavus and Mucor species. The low molar conductance values range (16-28.1Ohm- cm2 mol-1) indicated that all the complexes are non electrolytes. The magnetic susceptibility revealed that all the complexes are paramagnetic in nature. The metal-ligand ratio was found to be 1:2 in all the complexes. The infrared spectra suggested that the Schiff base behaves as a bidentate ligand. The antimicrobial studies revealed moderate activity against the tested organism when compared with the standards (Ciprofloxacin and Ketoconazole), and this activity increases by increasing concentration. And also the Metal Complexes showed higher activity than free Ligand due to chelation.Keywords: Salicyldehyde, 4-chloroaniline, Mn(II), Co(II), Zn(II) complexes, antimicrobial activity