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fatigue that might be associated with VDT use. The main factor appears to be lack of blinking. While scrolling on a VDT, the user has a tendency to stare and decrease blinking to avoid missing anything on the screen. As with contact lens wearers, it is necessary to remind VDT users to blink sufficiently often to lubricate the cornea. This simple act will decrease ocular fatigue significantly.Ergonomics come into play with the location of VDT screens and the type of glasses prescribed, especially with users who wear bifocal glasses. Bifocals have a limited range of clear vision that is related to the age of the patient and the strength of the bifocal correction.Clear vision is often limited to an area at chest height or below at a distance of 30 to 45 cm (12 to 18 in). Unfortunately, the VDT is usually at a greater distance and often at face level or higher-out of the range of bifocal glasses unless the user moves unnaturally close to the screen and holds his head up at an unnatural angle. This will often cause neck discomfort.This problem may be essentially elim¬ inated with the prescription of progres¬ sive lenses, which enable all distances to be in focus and allow the visualization of the VDT screen with natural head and neck positions. Trifocals may function better than bifocal lenses, but are not as versatile as progressive lenses. Alter¬ natively, attempts should be made to position the VDT in a way that mini¬ mizes neck discomfort when viewing the screen.
fatigue that might be associated with VDT use. The main factor appears to be lack of blinking. While scrolling on a VDT, the user has a tendency to stare and decrease blinking to avoid missing anything on the screen. As with contact lens wearers, it is necessary to remind VDT users to blink sufficiently often to lubricate the cornea. This simple act will decrease ocular fatigue significantly.Ergonomics come into play with the location of VDT screens and the type of glasses prescribed, especially with users who wear bifocal glasses. Bifocals have a limited range of clear vision that is related to the age of the patient and the strength of the bifocal correction.Clear vision is often limited to an area at chest height or below at a distance of 30 to 45 cm (12 to 18 in). Unfortunately, the VDT is usually at a greater distance and often at face level or higher-out of the range of bifocal glasses unless the user moves unnaturally close to the screen and holds his head up at an unnatural angle. This will often cause neck discomfort.This problem may be essentially elim¬ inated with the prescription of progres¬ sive lenses, which enable all distances to be in focus and allow the visualization of the VDT screen with natural head and neck positions. Trifocals may function better than bifocal lenses, but are not as versatile as progressive lenses. Alter¬ natively, attempts should be made to position the VDT in a way that mini¬ mizes neck discomfort when viewing the screen.
The pathologic findings of 232 consecutive cases of hepatocellular carcinoma (HCC) autopsied during the past ten years a t Kurume, Japan, were analyzed from the point of view of global epidemiology, in relation to clinical feature, and in regard to incidence, age, sex, etiologic factors, size of liver, changes in noncancer parenchyma, gross type of tumor, extrahepatic metastases, intravascular and intraductal growths, cancer cell histology, hepatitis B surface antigen (HBsAg) in hepatocytes and cancer cells, liver cell dysplasia, and frequency and clinicopathologic characteristics of minute HCC. Furthermore, postmortem hepatic arteriography and portography were done in I52 livers for comparison with gross anatomy and celiac angiograms. It was found that: (1) epidemiologically, HCC in Japan is distinct from that in the West that it is frequently encapsulated, livers are generally small because of frequent and advanced cirrhosis and small cancer, minute NCC, is not uncommon a t autopsy, cirrhosis most commonly associated is the one with thin stroma and medium size nodules, and micronodular cirrhosis is very rare despite frequent alcohol abuse; (2) HCC is increasing in incidence; (3) HBsAg is frequently found in parenchyma; (4) liver cell dysplasia is indirectly related to 11BsAg with no evidence for premalignancy; (5) the lung is the most frequent site of metastasis but peritoneal dissemination is unusual; (6) intraportal tumor growth is very common and the hepatic vein is less frequently affected;(7) growth in the major bile duct is frequently associated with intraportal growth and clinically presents as obstructive jaundice; and (8) tumor is supplied solely by arteries and celiac arteriograms are closely correlated with gross pathologic findings.
A comparison of the gross pattern of hepatocellular carcinoma (HCC) was made using autopsy material from Japan (378 cases), the United States (90 cases), and South Africa (16 cases). The tumor could be placed in three major gross patterns only if subcategories of each were created. The common major patterns were expanding, spreading, and multifocal. There was a relationship of gross pattern to the presence or absence of prior liver disease, and there were differences in frequency of occurrence of the various gross types in the material from the above‐mentioned countries.
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