Effects of intravitreal triamcinolone acetonide on retinal gene expression in a rat model of central retinal vein occlusion

Purpose  

The aim of this study was to investigate the effects of intravitreal triamcinolone acetonide on the alterations in retinal gene expression in a rat model of central retinal vein occlusion (CRVO).     

Subsurface microhardness of enamel and dentin after different external bleaching procedures

PURPOSE: To evaluate the influence of various bleaching systems on subsurface microhardness of enamel and dentin. METHODS: 60 bovine crowns were distributed among seven groups (A: Opalescence Xtra Boost, B: Opalescence Quick, C: Rapid White, D: Whitestrips, E: Opalescence 10%, F: Opalescence PF 15%). The crowns were sectioned and baseline hardness (Knoop) of enamel and dentin was assessed on the sectioned surface at various distances from the enamel surface. The sectioned surface was covered with wax and the enamel was treated for 10 days with the bleaching agents A-F according to manufacturers' instructions. Bleaching with C-F was conducted each day (C: twice per day for 10 minutes, D: twice per day for 30 minutes, E: 8 hours, F: 4 hours), systems A-B were applied on first and fifth days (A: twice for 10 minutes, B: 1 hour). Finally, hardness was re-assessed. Data were statistically analyzed to compare baseline hardness and final hardness in the respective groups (P< 0.05). RESULTS: Analysis showed that in Group C, hardness was significantly reduced in both enamel and dentin. In the remaining groups, significant reduction of hardness was observed up to the following depths [microm] in enamel; A: 250, B: 700, D: 300, E: 150, F: 150. In these groups no significant hardness changes were recorded in subsurface dentin.     

Type 2 diabetes susceptibility single-nucleotide polymorphisms are not associated with polycystic ovary syndrome

Two cohorts of women with polycystic ovary syndrome (PCOS), comprising 400 probands and affected sisters in 365 families and a case-control group including 395 women with PCOS and 171 healthy women with regular menstrual cycles, were studied to determine whether single-nucleotide polymorphisms (SNPs) identified as susceptibility loci in genomewide association studies of type 2 diabetes are also associated with PCOS. None of the 18 allelic variants in 10 genes previously shown to be associated with type 2 diabetes were found to be associated with PCOS, but some were associated with indices of beta cell function.     

The course of depression and anxiety in patients undergoing disc surgery: a longitudinal observational study

ObjectiveThis study examines longitudinal depression and anxiety rates in disc surgery patients in comparison to the general population, the change and associated determinants of depression and anxiety over time.MethodsThe longitudinal observational study refers to 305 consecutive disc surgery patients (age range: 18–55 years). Depression and anxiety was assessed with the Hospital Anxiety and Depression Scale. Random effects regression models for unbalanced panel data were used.ResultsDepression and anxiety decreases significantly during nine months after surgery. Depression rates vary between 23.6% (T0), 9.6% (T1) and 13.1% (T2). Only at T0 the depression rate differs significantly from the general population. Anxiety rates range between 23.7% (T0), 10.9% (T1) and 11.1% (T2). Compared to the general population anxiety rates are significantly higher at all three assessment points. Risk factors for anxiety or depression at the time of the surgery are psychiatric comorbidity before surgery, higher age, female gender, lower educational level, lower physical health status and higher pain intensity. Regarding depression and anxiety in the course of time significant time interactions were found for the existence of other chronic diseases, higher pain intensity and vocational dissatisfaction.ConclusionsCompared to the general population patients undergoing herniated disc surgery are often affected by depression and anxiety during hospital treatment and also in the course of time. Multimodal diagnostics regarding psychological well-being, pain and physical health status may help to identify this risk group. The assistance by mental health professionals during hospital and rehabilitation treatment may reduce poor postoperative outcome.     

Rheological properties of blood and their possible role in the circulation and development of intracranial hemorrhage in preterm infants

Blood viscosity and other rheological properties of blood have important effects on blood circulation. In preterm infants, blood viscosity (at given hematocrit), plasma viscosity and red cell aggregation are decreased compared to term neonates and adults. In addition, the Fahraeus-Lindqvist effect (i.e., decrease in blood viscosity with decreasing vessel diameter) is more pronounced in preterm infants. This suggests that blood flow through arteries, arterioles and veins is facilitated in preterm infants. The large neonatal red cells are less filterable and less able to enter small capillaries than adult red cells. This suggests that the passage of neonatal red cells through narrow capillaries and splenic pores is impaired. The high risk of intracranial hemorrhage in small preterm infants may in part result from poor red cell aggregation, impeded passage of their large red cells through narrow cerebral capillaries and raised blood viscosity due to rapid transfusion of adult blood.     

Die Fettembolie der Lungen als Todesursache. Ätiologie,Pathogenese und Beweisführung

Zusammenfassung Darstellung der Literatur zur Ätiologie, Pathogenese und Pathophysiologie der Fettembolie. Die Pathomorphologie der pulmonalen Fettembolie zeigt Ähnlichkeiten mit jener der Schocklunge. Besonders die wechselwirkenden Faktoren zwischen Fettembolie und Schock werden erörtert. Die Wirkungen der pulmonalen Fettembolie werden unterteilt in: mechanische, toxische und Schockinduzierende Wirkungskomponenten. Verfasser kommen zu der Ansicht, daß die pulmonale Fettembolie ein eigenständiges Krankheitsgeschehen darstellt. Es werden 26 Todesfälle mit und ohne Fettembolie untersucht. Die Fettembolie wird morphologisch und gravimetrisch quantifiziert. Bei geringen Graden der Fettembolie besteht eine schlechte Korrelation zwischen mikromorphologischem Grad und gravimetrischem Ergebnis. Bei hohem Grad der Fettembolie besteht scheinbar eine engere Korrelation. Zusätzlich finden sich bei hohen Fettemboliegraden Mikrohämorrhagien, Mikrothromben.Die todesursächliche Bedeutung der pulmonalen Fettembolie wird eingehend besprochen. Verfasser kommen zu dem Schluß, daß eine eingehende individuelle Beurteilung meist erforderlich sein wird. Die Diagnose Tod durch pulmonale Fettembolie ist eine Diagnose per exclusionem.

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Fat embolism of the lungs as the cause of death. Etiology, pathogenesis and reasoning

Summary A comprehensive survey is given of the most important theories of etiology, pathogenesis and pathophysiology of pulmonary fat embolism. Autopsy and microscopic examinations were performed on 26 corpses with different causes of death. The total contents of fat of the lungs was analyzed by chloroform extraction. Death due to pulmonary fat embolism was diagnosed in three cases. In those with whole fat contents of about 20 g or more the histological degree was equivalent to occlusion of half of all vessels. The histological feature resembled that of shock; hemorrhage and microthrombosis were regular findings. The functional and morphological relationships with shock are discussed. It is concluded that, at least in the initial stage, fat embolism is due to mechanical injury. This mechanism is possibly altered or enhanced by biochemical changes in later phases. Pulmonary fat embolism is a disease which may cause death if mechanical, toxic and shock-inducing effects lead to insufficiency of the cardio-respiratory system. In forensic cases death due to fat embolism should be diagnosed only after exclusion of other lethal factors. Posttraumatic cases often show competition with shock due to hemorrhage. It is important to relate the degree of fat embolism to preexisting diseases.

Wir danken Frau C. Smukowski und Frau P.S. Warkus für sorgfältige Assistenz.     

Plasma B-type natriuretic peptide levels in children with heart disease

Aim: To determine plasma B‐type natriuretic peptide (BNP) levels in children with heart diseases before medical or surgical treatment for monitoring therapeutic efficacy in an observational prospective clinical trial at tertiary care centre. Methods: In 522 paediatric patients at an age of 6.4 ± 5.2 years (mean ± SD; range: 14 days–18 years) with congenital heart disease (CHD), cardiomyopathies (CMP) or pulmonary arterial hypertension (PAH), plasma BNP levels were evaluated before and under treatment. Results: Most types of heart disease are associated with increased mean plasma BNP levels before treatment, with highest values in children with CMP (BNP 6165 pg/mL in dilated CMP vs. 817 pg/mL in hypertrophic, vs. 1236 pg/mL in restrictive CMP, each p < 0.05). Children with PAH showed a significant decrease in BNP levels under medical treatment (mean BNP 981 pg/mL before vs. 26 pg/mL under treatment, p < 0.05). Children with univentricular CHD undergoing surgical staged palliation showed a significant decrease in BNP levels after bidirectional cavopulmonary anastomosis (BDCP) (BNP 109 pg/mL before vs. 70 pg/mL after BDCP, p < 0.05). Conclusion: Plasma BNP levels are elevated in children with heart disease before treatment and are a useful laboratory parameter under treatment during long‐term follow‐up.     

Cost-effectiveness of magnetic resonance imaging and enteroclysis in the diagnostic imaging of Crohn's disease

OBJECTIVES: To compare the cost-effectiveness of magnetic resonance imaging (MRI) and enteroclysis in patients with Crohn's disease (CD). METHODS: A decision analytic model was performed considering the correct diagnoses of CD and complications such as fistulas and abscesses as effects. Costs were estimated in Euro([symbol: see text]) using German fee schedules. RESULTS: MRI was more effective and more costly compared with enteroclysis. Incremental cost-effectiveness of MRI versus enteroclysis was [symbol: see text]1,595 per additional correctly diagnosed patient. CONCLUSIONS: The use of MRI in the work-up of patients with CD cannot be generally recommended from an economical perspective, but results of sensitivity analysis suggest that in patients with high prevalence of complications, MRI becomes as cost-effective as enteroclysis, which is accepted standard diagnostic imaging.