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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  Evidenzbasierte Medizin - Anspruch und Wirklichkeit; 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft; 20040923-20040926; Berlin; DOC04dogFR.04.12 /20040922/
    Publication Date: 2004-09-21
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG); 20060921-20060924; Berlin; DOC06dogP040 /20060918/
    Publication Date: 2006-09-19
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Total displacement of vitreous by an expanding bubble of a perfluorocarbon gas was studied in cynomolgus monkeys. The clinical observations and the gross dissection suggested that cortical vitreous might have been stripped from the retina; however, electron microscopy of frozen sections demonstrated that the collagen structure of the vitreous was compressed against the retina.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A method is presented that allows the quantitative determination of the blood flow in retinal arteries in human beings. Television fluorescein angiograms are used as input. This method does not need any gauge procedures since all the necessary information is taken from the image itself. Also, the patients' eye movements do not introduce errors because their influence is removed by the computer program.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Netzhaut-Vernarbungen nach unterschiedlichen thermischen Reizen (Diathermie, Lichtkoagulation oder Kryopexie) ähneln einander. Zuerst entsteht eine thermische Uveitis. In Abhängigkeit vom Ausmaß der thermischen Schädigung bzw. der daraus resultierenden retinalen Nekrose entstehen verschiedene Vernarbungstypen. Ist eine kryogene retinale Nekrose gering, reicht nur bis zum Niveau der Membrana limitans externa und verschont dabei die äußeren Körnerzellen, so kommt es sogar zur Regeneration der zerstörten Stäbchen. Bei ausgeprägter retinaler thermischer Nekrose kann die Vernarbung zunächst innerhalb der Netzhaut stattfinden. Zu nennen sind hierbei die Vernarbung und Ad-häsionsausbildung durch Verfingerung und durch Desmosomen. Ist die thermische Schädigung noch stärker, so kommt es zu Defektbildungen in den begrenzenden zwei Basalmemhranen. Der Vernarbungsprozeß greift auch auf die angrenzenden mesenchymalen Gewebe über. Dabei entstehen chorioretinale und im Extremfall vitreoretinale Vernarbungen. Diese tierexperimentellen Befunde lassen sich als Modellvorstellungen für die bei Patienten beobachteten Vernarbungsprozesse nach abgelaufener Uveitis heranziehen. Anhand der besprochenen histologischen Befunde erscheint die Klärung des Entstehungsvorgangs einer chorioretinalen Narbe und einer pathologischen vitreoretinalen Adhärenz als Folge der Uveitis möglich.
    Notes: Summary The retinal scars caused by different thermal injuries (diathermy, photocoagulation or cryosurgery) are similar in structure. At first we have a thermal uveitis. The different types of retinal adhesions are depending upon the amount of thermal injury and resulting retinal necrosis. If the cryogenic retinal necrosis is small and only extends to the level of outer limiting membrane, but spares the outer nuclei, the damaged rods will regenerate. If the thermal retinal necrosis goes deeper, the scarring will occur intraretinal: there will be an adhesion by interdigitation or by desmosomes. If in addition the thermal insult necroses the two lining basal membranes, the scarring will extend into the neighbouring mesenchymal tissues. It will result in a chorioretinal or-more seldom-in a vitreoretinal scarring. These animal experiments might represent a model for the retinal scarring we observe in patients with uveitis. With these histological findings it seems possible to explain the chorioretinal and the pathological vitreoretinal adhesion as a scarring caused by uveitis.
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  • 6
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a pilot study, an expanding perfluorocarbon gas was injected into the retrohyaloidal space for treating giant tear detachments. Using the balloon-gas procedure with a single gas injection, a bubble was obtained that was large enough to tamponade a giant tear without prior drainage of subretinal fluid or vitrectomy. The procedure was performed under subconjunctival anesthesia in order to preserve the patient's light perception, the fading of which served as a safeguard against excessive gas injection. The posterior hyaloidal membrane was only attached to the anterior flap of the tear and to the circumference of the retina anterior to the equator. The retrohyaloidal gas injection was not followed by star-fold formation or other evidence of preretinal proliferation. During the follow-up, the detached posterior hyaloidal membrane appeared to have collapsed on the anterior retina in concertina-like folds. Reattachment occurred in four of the five cases; no retina redetached during an average follow-up of 2 years.
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  • 7
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Perfluorkohlenstoffgase eignen sich besonders zur Behandlung von Netzhautablösungen mit Löchern im Bereich des hinteren Pols. Die Perfluorkohlenstoffgase nehmen intraocular an Volumen zu, zum anderen verweilen sie sehr lange im Auge. Zur Anwendung ist keine vorherige Vitrektomie notwendig. Der Patient muß aber hierbei den Kopf nach unten halten, damit die Gasblase in den Bereich des hinteren Pols gelangt. Die vorgestellten 4 Perfluorkohlenstoffgase haben den entsprechenden Ausdehnungskoeffizienten, um eine genügend große intraoculare Gasblase zur Tamponade von Löchern am hinteren Pol zur Verfügung zu stellen; dies geschieht durch allmählichen Ersatz des Glaskörpers durch das Gas. Es genügen hierfür 1–2 ccm. Der intraoculare Raum für ein solches Volumen wird entweder erreicht durch eine Punktion der subretinalen Flüssigkeit oder durch eine Injektion von 0,6 ccm C2F6-Gas (dieses nimmt auf das 3,3-fache seines Volumens zu) ohne Punktion. Kann der Patient hingegen den Kopf nicht nach unten halten, wird das nunmehr notwendige große intraoculare Gasvolumen dadurch erreicht, daß der größte Teil des flüssigen Glaskörpers durch eine intraoculare Injektion von 0.9 ccm C4F10-Gas (dieses nimmt auf das 5-fache seines Volumens zu) verdrängt wird.
    Notes: Abstract Expanding, long-lived intraocular perfluorocarbon gas bubbles can make possible the repair of retinal detachments with holes or tears in the posterior pole. Vitrectomy is not necessary for injecting the gas. The patient should be prone in order to bring the gas bubble to the top of the visual axis. Four perfluorocarbon gases have the appropriate coefficient of expansion to provide adequate intraocular gas volumes by displacing the fluid vitreous. Volumes of 1 to 2 cc are sufficient. Intraocular space for these amounts can be obtained either by draining subretinal fluid or by injecting 0.6 cc of C2F6 (which expands 3.3 ×) without draining. If the patient cannot tolerate being prone, most of the fluid vitreous can be displaced with an intraocular injection of 0.9 cc of C4F10 (which expands 5 ×).
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a prospective study on the use of perfluorocarbon gases (CF4, C2F6, C3F8) without prior mechanical vitrectomy, 51 retinal detachments that were not suitable for scleral buckling were treated by injection of a small bubble of gas into the vitreous to form a tamponade. There were 23 patients with giant tears, 16 with posterior holes, 9 with breaks at different latitudes, and 3 in whom the gas was used for diagnostic purposes. The gases were sustained at therapeutic volumes for 10–70 days. The tears were sealed with argon or krypton laser. The overall reattachment rate was 71%. Postoperative visual acuity improved or remained the same in all patients with reattached retina. In a follow-up of 1 year - 38 months there were no late complications, such as cataract, glaucoma, keratopathy, or subsequent visual deterioration.
    Type of Medium: Electronic Resource
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