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authors identified four class I studies, three class II studies, and five class III studies on clinical findings and circumstances. The indicators of poor outcome after CPR are absent pupillary light response or cornealreflexes, and extensor or no motor response to pain after 3 days of observation (level A), and myoclonus status epilepticus (level B). Prognosis cannot be based on circumstances of CPR (level B) or elevated body temperature (level C). The authors identified one class I, one class II (...) (level B). Ten class IV studies on brain monitoring and neuroimaging did not provide data to support or refute usefulness in prognostication (level U).Pupillary light response, cornealreflexes, motor responses to pain, myoclonus status epilepticus, serum neuron-specific enolase, and somatosensory evoked potential studies can reliably assist in accurately predicting poor outcome in comatose patients after cardiopulmonary resuscitation for cardiac arrest.
Positive angle kappa: a sign of albinism in patients with congenital nystagmus. To determine whether the association of positive angle kappa and congenital nystagmus is a distinguishing feature of albinism.Observational case series.Prospective examination of the location of the corneal light reflex in patients with albinism and idiopathic congenital nystagmus.A positive angle kappa in at least one eye was noted in 20/21 (95%) patients with albinism versus 4/12 (33%) patients with congenital
institution.Chart review of patients who underwent super maximum levator resection with or without superior tarsectomy. Data regarding eyelid position, surgical outcome, and postoperative complications were evaluated.Margin reflex distance-1 (distance [mm] between corneal light reflex and upper eyelid margin), bilateral eyelid symmetry, and postoperative complications.A statistically significant improvement in ptosis correction was demonstrated when integrating the superior tarsectomy with the super maximum (...) levator resection (P = 0.029). In addition, the superior tarsectomy significantly decreased the incidence of undercorrection (margin reflex distance-1 values less than 2.0 mm) compared with the super-maximum levator resection alone (12.5% vs. 70%; P = 0.023). Improved postoperative eyelid symmetry within 1.0 and 1.5 mm was demonstrated in cases treated by the superior tarsectomy. Postoperative complications were similar in both treatments.The super maximum levator resection combined with superior
Abnormal foveal avascular zone in nanophthalmos. To evaluate the foveas of nanophthalmic patients.Retrospective observational case series.Four nanophthalmic patients examined between April 2005 and April 2006 were included. Visual acuity (VA), refractive correction, axial length, corneal diameter, presence or lack of foveal light reflex, as well as fluorescein angiograms (FAs), and optical coherence tomography (OCT) scans of the maculae were evaluated.None of the eight eyes had a foveal light (...) reflex, corresponding to lack of a normal foveal pit on OCT. Fluorescein angiography showed no normal foveal avascular zones; all were either completely absent or small and rudimentary.Nanophthalmic patients rarely have best-corrected visual acuity (BCVA) better than 20/40 at any point in their lives, even with an absence of known complications, such as uveal effusion or glaucoma. In many patients, this visual deficiency may correspond to an absent or rudimentary foveal avascular zone and lack
to evaluate the technique.Prospective noncomparative surgical trial in which preoperative and postoperative symptoms, margin reflex distances, vertical palpebral aperture (PA), lagophthalmos, and corneal findings were recorded. The data were analyzed at 6 months after surgery using the Wilcoxon sign-rank test for nonparametric data.Fourteen consecutive adult patients (15 eyelids) with chronic lagophthalmos and paralytic ectropion.Patients underwent aug-LTS-T. This consisted of a long strip (10-15 mm (...) ) that is attached to the outer temporal orbital rim, at a point higher than a conventional LTS. It included removal of a small part of the upper eyelid anterior lamella laterally to pass the long strip up high enough.Improvement of symptoms, reduction of lower margin reflex distance, lagophthalmos, and improvement of corneal signs.Minimum follow-up was 6 months. There was a significant reduction in PA (P = 0.005) and lagophthalmos (P = 0.0002) with improvement of corneal signs (14 of 15 eyelids = 93%). Surgery
-iminoethyl)-lysine (4 mg/kg), was injected intraperitoneally immediately after CLP to produce the CLP + L-N6-(1-iminoethyl)-lysine group to exclude the influence of depressed hemodynamics on neurologic impairment.It was found that administration of AM 281 could prevent the hemodynamic changes induced by sepsis. Reflex responses, including the pinna, corneal, paw or tail flexion, and righting reflexes, and the escape response significantly decreased in the CLP and CLP + L-N6-(1-iminoethyl)-lysine groups (...) at 48 hrs after the surgery. In contrast, no changes in these reflex responses were found between the CLP + AM 281 and control and sham groups. In addition, no effects of the administration of AM 281 on neurologic function and mortality rate in the control group were found. Tissue caspase-3 levels were elevated at 48 hrs after CLP in the CLP alone group (means +/- sd: control, 3.9 +/- 0.4; sham, 4.2 +/- 0.4; CLP, 7.1 +/- 1.0 [p < .01]; CLP + AM 281, 4.0 +/- 0.5 densitometric units). In addition
immunodeficiency virus-associated lipodystrophy were treated with midfacial lifting combined with dermis fat posterior lamellar spacer grafting.Preoperative and postoperative measurements of eyelid position, margin-to-reflex distance (defined as the distance from the upper eyelid to the central corneal light reflex and the distance from the lower eyelid to the corneal light reflex), lagophthalmos, corneal staining, presence of ocular surface symptoms, and patient satisfaction.All patients who underwent dermis
was measured by the prism and cover test or prism and cornealreflex test.Mean preoperative deviation of the study group was 17.8 +/- 9.7 prism diopters (PD) of exophoria/tropia. In this group, 70.2% had exophoria and 27.7% had exotropia. In the control group exophoria was found in 75% of the persons whereas none of them had any heterotropia. Mean deviation in the control group was 4.7 +/- 5.1 PD of exophoria. Postoperatively, the angle of exophoria/tropia improved to 12.8 +/- 8.5 PD, which was different
flick tests performed at 52.5 +/- 0.5 degrees C before injection and at intervals up to 30 h after injection. Catalepsy and loss of cornealreflexes were considered as signs of supraspinal toxicity.In vitro drug release was observed for more than 6 days. Epidural analgesic effects of tramadol released from PHB microspheres were observed for 21 h, whereas an equal dose of free tramadol was effective for less than 5 h. No signs of toxicity were observed.Controlled release of tramadol from PHB
randomly assigned to receive one of four different foldable IOLs after phacoemulsification: Storz Hydroview H60M, Corneal ACR6D, AMO SI40NB, and Alcon AcrySof MA60BM. Examinations on days 7, 30, 90, 180, 360, and 720 after surgery included ophthalmologic examination, slit-lamp biomicroscopy, and photography using red reflex and focal illumination of the anterior IOL surface.Best-corrected visual acuity was measured at each examination. In addition, the anterior capsule opacification and the membrane (...) growth on the anterior IOL surface were graded according to a subjective method by the same researcher.The fibrosis of the anterior capsule was more frequently observed in the group using Corneal ACR6D and AMO SI40NB. The Hydroview and ACR6D groups showed a higher percentage of cases with membrane growth from the rhexis edge on the anterior IOL surface. AcrySof showed the lowest presence of fibrosis of the anterior capsule, and no membrane growth was noted.Anterior capsule opacification is an index
, based on measured arterial propofol plasma concentrations. Clinical pharmacodynamics were assessed by reaction on acoustic stimuli, eyelid reflex and corneal reflex.The drugs did not differ in pharmacodynamics with respect to EEG (EC(50) 2.1+/-0.6 for Diprivan and 2.1+/-0.5 microg/ml for Propofol Fresenius) and clinical signs. The pharmacodynamic model was characterized by a steep concentration effect relationship and a distinct hysteresis between propofol plasma concentration and effect (k(e0) 0.12
The orbicularis oculi response after hemispheral damage. The corneal and blink reflexes were evaluated in 20 normal subjects and in 30 patients with motor deficits secondary to unilateral hemispheral lesions of vascular origin. In the normal population there were no differences between subjects below and subjects above 50 years of age. In the patients the reflex evoked by electrical stimulation of the cornea of the clinically affected side was depressed in 24 out of 30 cases. The depression (...) . The changes of the cornealreflex and of the R2 component of blink reflex were similar, but the blink reflex had a greater safety factor. The patients with an abnormal cornealreflex had more extensive damage than had the patients with normal corneal response, as shown by computer tomography, but the site of the lesion was comparable in the two groups. Conduction through the brain stem circuits mediating the orbicularis oculi response is normally under pyramidal facilitatory influences while facial
Seizures triggered by blinking in a non-photosensitive epileptic. An epileptic girl with Lennox-Gastaut syndrome had seizures triggered specifically by blinking, but not by other eye movements or by photic stimulation. Electrographic and clinical seizures were most reliably precipitated by repetitive blinking produced voluntarily on command, by reflex blinking on corneal stimulation, or by psychogenic triggers of blinking such as social stress or cognitive effort.
Circadian rhythms in the body temperatures of intensive care patients with brain lesions. The body core temperatures of 31 patients suffering from severe cerebral lesions were measured. Evidence for the existence or nonexistence of circadian rhythms in these patients was found to be associated with diagnosis (acute versus chronic lesions), with the level of consciousness, and with neurological findings (such as best motor response and pupillary reaction), but not with heart rate, cornealreflex
Idiopathic and symptomatic trigeminal pain. The trigeminal reflexes (cornealreflex, blink reflex, masseter inhibitory periods, jaw-jerk) and far field scalp potentials (nerve, root, brainstem, subcortical) evoked by percutaneous infraorbital stimulation were recorded in 30 patients with "idiopathic" trigeminal neuralgia (ITN) and 20 with "symptomatic" trigeminal pain (STP): seven postherpetic neuralgia, five multiple sclerosis, four tumour, two vascular malformation, one Tolosa-Hunt syndrome (...) , and one traumatic fracture. All the patients with STP and two of those with ITN had trigeminal reflex abnormalities; 80% of patients with STP and 30% of those with ITN had evoked potential abnormalities. The results indicate that 1) trigeminal reflexes and evoked potentials are both useful in the examination of patients with trigeminal pain, and in cases secondary to specific pathologies provide 100% sensitivity; 2) in "symptomatic" and "idiopathic" paroxysmal pain the primary lesion affects
with a return of the corneal blink reflex. 4. Basal NA levels in conscious animals were not affected by an intravenous infusion of equally radioactive solutions of either imidazoline (clonidine) or imidazole (mivazerol) alpha2-adrenoceptor agonists. The dose rate employed for each compound was 2 microg kg(-1) h(-1) over 2 h. 5. The co-administration of intravenous clonidine or mivazerol, each at 2 microg kg(-1) h(-1) for 2 h, with sodium pentobarbitone (85 mg kg(-1), i.p.), produced a marked and prolonged
Guaifenesin alone or in combination with ketamine or sodium pentobarbital as an anesthetic in rabbits. Guaifenesin was administered alone and in combination with ketamine or sodium pentobarbital to adult New Zealand white rabbits. A solution of 5% guaifenesin in 5% dextrose given intravenously at a dosage of 200 mg/kg, abolished the pedal, palpebral and cornealreflexes for up to 15 minutes with little influence on cardiopulmonary function. Guaifenesin (200 mg/kg, intravenously) and ketamine
levator aponeurosis advancement. The distance between the upper eyelid margin and the central corneal light reflex was measured preoperatively with the patient in both the upright and the supine position, 10 minutes after injection of 1.0 mL of anesthetic solution (2% lidocaine with 1:100,000 epinephrine and 12 U hyaluronidase per mL) in the supine position, intraoperatively after skin closure in the supine position, and 1 week or more postoperatively in the upright position. The ptotic lid
. Dimethyl-[2-[2-(3-phenyl-[1,2,4]oxadiazol-5-yl)-phenoxyl]-ethyl]-amine hydrochloride (BIIR 561 CL) combines both, AMPA receptor - and Na(+) channel blocking properties in one molecule. Here, BIIR 561 CL was investigated in vivo. BIIR 561 CL protected mice against AMPA-induced toxicity with an ED(50) value of 4.5 mg kg(-1) following subcutaneous (s.c.) administration. A 0.1% solution of BIIR 561 CL provided local anaesthesia in the cornealreflex test in rabbits. In mice, the compound prevented tonic