[Retinal and trabecular degeneration in glaucoma: new insights into pathogenesis and treatment]. / Dégénérescences rétinienne et trabéculaire dans le glaucome : pathogenèse et perspectives thérapeutiques.

Academic and industrial research has brought new insights into the pathogenesis of glaucoma, aiming at identifying and targeting specific mechanisms to improve our current therapeutic strategy. Retinal neurodegeneration is still the main focus, whether in terms of extrinsic factors such as neurotrophin deprivation, glutamate toxicity, vascular deficiency and neuro-inflammation from glial cells, or in terms of retinal ganglion cell intrinsic sensibility to proapoptotic signals. However, glaucoma is not solely a retinal disease but also involves retinal and trabecular meshwork degeneration, extending into and/or even originating from the brain. The present review summarizes our current knowledge of key mechanisms involved in glaucoma degeneration, focusing on the direction of current research towards the future of glaucoma therapy.

Flexor tendon excursion and load during passive and active simulated motion: a cadaver study.

The aim of this study was to quantify the amount of tendon excursion and load experienced during simulated active and passive rehabilitation exercises. Six cadaver specimens were utilized to examine tendon excursion and load. Lateral fluoroscopic images were used to measure the excursions of metal markers placed in the flexor digitorum superficialis and profundus tendons of the index, middle, and ring fingers. Measurements were performed during ten different passive and active simulated motions. Mean tendon forces were higher in all active versus passive movements. Blocking movements placed the highest loads on the flexor tendons. Active motion resulted in higher tendon excursion than did passive motion. Simulated hook position resulted in the highest total tendon excursion and the highest inter-tendinous excursion. This knowledge may help optimize the management of the post-operative exercise therapy regimen.

Golden Retriever uveitis: 75 cases (1994-1999).

OBJECTIVE: To document the presenting ocular signs and the clinical course of Golden Retriever dogs with a progressive anterior uveitis, often associated with the histologic presence of iridociliary cysts. Animals studied Seventy-five Golden Retriever dogs (142 affected eyes) referred to a private practice referral ophthalmology clinic between 1994 and 1999. Procedures Complete ophthalmic evaluation with slit-lamp biomicroscopy, indirect ophthalmoscopy, applanation tonometry, and gonioscopy. Hematology, serum biochemical evaluations, and serologic titers for endemic infectious agents were also used in selected cases. RESULTS: The age range of affected dogs was 4.5-14.5 years, with a mean age of 8.6 +/- 2.1 years. The majority of the dogs (n = 66) were affected in both eyes at first presentation. The sex distribution included 4 intact males, 32 neutered males, and 39 spayed females. Hematology, serum biochemical evaluations, and serologic titers for endemic infectious agents failed to demonstrate any underlying disorder. The ophthalmic hallmark of this syndrome was the appearance of pigment on the anterior lens capsule, often in a radial orientation. This capsular pigment was seen both with and without associated uveal cysts. Although single to multiple iridociliary cysts were noted clinically in only 13.3% of the cases, cysts were common on histopathology of advanced glaucomatous, blind eyes. Fibrin was observed in the anterior chamber of 37% of the cases, and often was a precursor for glaucoma. Cataract formation (37%) and glaucoma (46%) were frequent sequelae to the uveitis. Posterior synechiae formation occurred in 50% of the cases. Histopathologic analysis of four enucleated eyes and the eviscerated specimens from 14 glaucomatous eyes demonstrated thin-walled iridociliary epithelial cysts in 3/4 and 12/14 cases, respectively. Microscopically, little to no uveal inflammatory infiltration was commonly noted. Conclusion The overall prognosis for this progressive uveitis in Golden Retriever dogs is guarded, with 46% of the eyes becoming blind due to glaucoma. Iridociliary cysts in Golden Retriever dogs may lead to the development of glaucoma in this breed.

Combinatorial electrochemistry: A highly parallel, optical screening method for discovery of better electrocatalysts

Combinatorial screening of electrochemical catalysts by current-voltage methods can be unwieldy for large sample sizes. By converting the ions generated in an electrochemical half-cell reaction to a fluorescence signal, the most active compositions in a large electrode array have been identified. A fluorescent acid-base indicator was used to image high concentrations of hydrogen ions, which were generated in the electrooxidation of methanol. A 645-member electrode array containing five elements (platinum, ruthenium, osmium, iridium, and rhodium), 80 binary, 280 ternary, and 280 quaternary combinations was screened to identify the most active regions of phase space. Subsequent "zoom" screens pinpointed several very active compositions, some in ternary and quaternary regions that were bounded by rather inactive binaries. The best catalyst, platinum(44)/ruthenium(41)/osmium(10)/iridium(5) (numbers in parentheses are atomic percent), was significantly more active than platinum(50)/ruthenium(50) in a direct methanol fuel cell operating at 60 degreesC, even though the latter catalyst had about twice the surface area of the former.

Forecasting hospital reimbursement.

The changes in reimbursement to hospitals by third party payers make it essential for hospital administrators to forecast their hospitals' reimbursement potential. Although models have been developed to predict and maximize census, forecast future demand for hospital care, and forecast the revenue budget, none of the models addresses how the physician directly affects the hospital reimbursement potential through office practice admissions. This study analyzes the admitting physician's patients by third party payer and presents a method to assist in using a physician's past hospital admissions to forecast a hospital's admissions and reimbursement potential.

Radiology department management system: technologists' costs.

We developed a series of management reports to compare actual costs against expected costs for radiology departments on a more detailed level than previously available. We first developed labor standards for the most commonly employed diagnostic examinations and showed that increased patient complexity (resulting from, for example, immobility, precautions status, etc.) also increased the examination times up to 2.6-fold compared with the time required for average patients. Using labor standards and budgeted and actual volumes of average and complex patients, we calculated four types of variances: volume variance, examination mix variance, patient complexity variance, and technologist efficiency variance. Monitoring the technologist efficiency variance over time could be one key piece of information for improving departmental productivity.

Measuring productivity in an ambulatory setting.

Planning, budgeting, and effective management depend on some measurement of productivity. Until now, there has not been a concerted effort to look for means of measuring productivity of health care providers in an ambulatory setting. The author presents a simple technique for measuring productivity that can be agreeable to both managers and providers.

Psychographic profiles: aid to health care marketing.

Psychographic data contribute to health care promotion by providing a marketing tool for the health care manager. A complete knowledge of the patient populations' characteristics provides the health care manager with answers to many patient needs. Health care facilities can change or strengthen staff to meet consumer expectations thanks to the information provided by psychographic data.