Evaluation of scleral incisions and their effects on corneal curvature in manual small-incision cataract surgery

Purpose:Incisions in cataract surgery can be modified in various ways in terms of size, shape, and axis to reduce or tailor astigmatism. This study was conducted to examine the effect of site (superior vs, temporal) and shape (frown vs. V-shaped, chevron) of scleral incisions for cataract surgery on corneal curvature.Methods:The prospective study was carried out on 200 consecutive patients with senile cataract and who were planned for surgery at a tertiary eye hospital in north India. The placement of the incision was decided by the steeper corneal meridian—whether superior or temporal—and then patients of these two groups were randomized for frown and V-shaped incision; in this way, four groups of 50 patients each were formed. Follow-up was done on day 1, at 2 weeks, 4 weeks, 8 weeks, and 12 weeks. At each follow-up, post-operative keratometry with routine postoperative examination was done. The results were statistically analyzed by using student’s t-test, Chi-squared test, and the Pearson correlation coefficient.Results:In all the four groups, the difference of preoperative astigmatism and surgically-induced astigmatism was statistically highly significant. The analysis of uncorrected visual acuity (UCVA) was statistically significant (P < 0.05) on postoperative day 1 and at 2, 4, and 12 postoperative weeks; it was statistically insignificant (P > 0.05) at postoperative week 8.Conclusion:Temporal incisions result in lesser postoperative surgically induced astigmatism (SIA) than superior incisions. Chevron incisions result in minimal change in corneal curvature. This effect can be utilized to tailor the postoperative astigmatism.     

Arrhythmogenic right ventricular dysplasia: polymorphism of clinical manifestations

We observed 15 patients with arrhythmogenic right ventricular dysplasia (ARVD): 9 with definite and 5 with probable ARVD (modified European Criteria, 2010). Eight patients had typical ARVD (frequent right ventricular extrasystoles, nonsustained right ventricular tachycardia without heart failure with or without myocarditis). Five patients had ARVD with progressive heart failure (right- or biventricular with or without myocarditis). Two patients had full scale arrhythmic form (sustained right ventricular tachycardia without or with right ventricular dilation, with or without myocarditis). In 3 cases diagnosis was confirmed morphologically or with DNA-diagnostics. This material allowed us to highlight the following specific points related to diagnostics of ARVD. Detection of fat at MRT is not obligatory for diagnosis, fat can be detected by MSCT; ventricular arrhythmias can move backwards in the picture of the disease; leading clinical manifestation can be unexplained right ventricular insufficiency; ARVD can be combined with other genetic cardiomyopathies as well as with infectious immune myocarditis (up to 50% of patients); elevated titer of anticardiac antibodies is not characteristic for isolated ARVD; myocardial biopsy allows to verify both ARVD and concomitant myocarditis. The paper also contains discussion of the role of myocarditis in various forms of ARVD and possibilities of its diagnosis and treatments.     

Pregnancy: The effect of RU486 on progesterone and oestrogen receptor concentration in human decidua on early pregnancy

Concentrations of progesterone receptor (PR) and oestrogen receptor(ER) were measured by radioligand assay in decidual tissue ofwomen undergoing termination of early pregnancy (amenorrhoeaup to 49 days). Pregnancies were terminated by vacuum aspirationat 12 or 36 h after oral administration of placebo or antiprogestinRU486 in different doses. Treatment with RU486 decreased decidualPR content, the effect being observed at 12 h as well as at36 h after 600 mg RU486 and at 36 h after 3 x 25 mg RU486 givenat 12 h intervals. PR concentration 12 h after a single doseof 25 mg RU486 was not affected. ER content was unchanged at12 h after RU486 but increased 36 h after 600 mg and 3 x 25mg RU486. Our data suggest that apart from blocking progesteroneaction, RU486 may exert its abortifacient effect through decreasingthe PR concentration. The simultaneous decrease of PR concentrationand an increase of ER concentration changes the balance betweenthem in favour of ER, which might also play a role in the abortifacienteffect of RU486.     

Discovery of B cell antigen on blast cells of patients with chronic myeloid leukemia

The presence of a common antigen on B lymphocytes of healthy blood donors and on myeloblasts of patients with chronic myeloid leukemia (CML) in the blast crisis (BC) stage was established with the aid of an antimyeloblast serum by the indirect surface immunofluorescence test. In the cytotoxic test this antigen was found on the blast cells of 27 patients with CML in the BC stage and in three of 11 patients with acute lymphatic leukemia, in one of eight patients with chronic lymphatic leukemia, and in both of two patients with undifferentiated leukemia. No antigen was found on the peripheral blood cells of healthy donors by this test.Oncologic Scientific Center, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR L. M. Shabad.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 87, No. 6, pp. 574–576, June, 1979.