Scatter photocoagulation for choroidovitreal neovascularization.

Two patients developed choroidovitreal neovascularization subsequent to intense, repeated photocoagulation of a choroidal melanoma. Scatter photocoagulation to the ischemic zone of peripheral retina resulted in prompt, sustained regression of the new vessels. Scatter photocoagulation should be considered as a therapeutic alternative to focal ablative photocoagulation for patients who develop choroidovitreal neovascularization.

A classification and coding system for information retrieval on diagnosis and therapy.

The Wilmer Information System uses an updated hierarchical code derived from the ICD-9 code. The process of coding has been made as simple as possible by the development of Customized Coding Sheets containing the most commonly used diagnoses for each subspecialty. Interactive data entry and retrieval programs have been developed which allow great flexibility in precisely selecting either individual patients or groups of patients for chart review.

The effects of hospital rate-setting programs on volumes of hospital services: a preliminary analysis.

This article describes a preliminary study of the effects of State rate-setting programs on volumes of hospital services, specifically admission rates, occupancy levels, and average lengths of stay. A volume response to rate-setting may be anticipated as a result of program effects on hospital costs or charges as well as on hospitals' behavioral incentives. We analyzed data for samples of hospitals and counties in States with and without rate-setting programs for the 9-year period 1969 to 1978. The results suggested that rate regulation has brought about, in some States, an increase in hospital occupancy by increasing patients' lengths of stay. Few programs have had a measurable effect on the admission rate. Programs that regulate per diem rates seem to produce more consistent and predictable volume effects than those controlling charges. The findings were generally consistent with prior hypotheses and partially account for earlier findings regarding the effects of rate-setting programs on hospital costs.

Lactate dehydrogenase levels and isozyme patterns. Measurements in the aqueous humor and serum of retinoblastoma patients.

Lactate dehydrogenase (LDH) activity was determined in 24 cases of histologically proved retinoblastoma. The mean level was 1,825 IU/L, with a range of 10 to 15,920 IU/L. Twenty-two patients had elevated aqueous humor LDH levels. In two, the aqueous humor level was within the normal range. Student's t testing showed a highly significant difference between cataract and retinoblastoma aqueous humor. The retinoblastoma aqueous humor to blood ratio ranged from 0.045 to 58,529--not a good index of retinoblastoma. Isozyme patterns of retinoblastoma aqueous humor were statistically similar to those of normal cataract aqueous humor. The serum LDH level of cataract patients was not statistically different from that of retinoblastoma patients. The LDH 5/LDH 1 ratio of retinoblastoma aqueous humor ranged from 0.042 to 27.05--not a good index of retinoblastoma, as 28 of 34 aqueous samples of cataract patients had LDH 5 greater than LDH 1. Ten of 13 retinoblastoma patients had aqueous humor LDH 5 greater than LDH 1. The best index of the presence or absence of retinoblastoma is the total aqueous humor LDH level.

Aqueous humor lactate dehydrogenase in retinoblastoma patients. Clinicopathologic correlations.

Aqueous humor lactate dehydrogenase (LDH) levels were assayed for 23 patients with histologically proved retinoblastoma. The mean aqueous level was 1,886 IU/liter. Twenty-one of these patients had an aqueous humor LDH level above the normal mean. Clinicopathological parameters were determined and evaluated using standard statistical formulas. Only the presence of tumor in the anterior chamber correlated significantly with the aqueous humor LDH level. The following clinical features did not correlate with aqueous humor LDH levels: sex, family history, bilaterality, prior treatment, presentation age, enucleation age, and metastasis. The following pathological features did not correlate with aqueous humor LDH levels: calcification, necrosis, rosettes, inflammation, choroidal or optic nerve invasion, or neovascularization.

Catecholamine metabolites in the aqueous of retinoblastoma.

The aqueous humor of five patients with histologically proven retinoblastoma were analyzed for the main catabolic products of norephinephrine and epinephrine. In each case, there were no detectable levels of normethanephrine, metanephrine, vanilmandelic acid (VMA), and 3-methoxy, 4-hydroxy phenoglycol. The techniques are sensitive to 1 microgram/ml but will not detect the presence of homovanillic acid (HVA).

Private health insurance in 1974: a review of coverage, enrollment, and financial experience.

In 1974, more than three-fourths of the civilian population had substantial economic protection through private health insurance against the costs of hospital and surgical care. Smaller proportions were covered at least in part for other health care costs, usually after payment of deductibles and coinsurance. Consumers got back 87 percent of their premium dollars in the form of benefits. The rise in premium income in 1974 lagged 4 percentage points behind the growth in claims incurred. The result was a net underwriting loss of $359.7 million or 1.3 percent of premium income. Most consumers bought their health insurance protection through insurance companies, although Blue Cross-Blue Shield plans served about two-fifths of the insured population for hospital-associated care. In addition, about 6 percent received health care through independent prepayment and self-insured plans.