Scleral fixation of posterior chamber intraocular lenses using fascia lata to cover the knots

BACKGROUND AND OBJECTIVE: To describe the use of fascia lata to cover the polypropylene knots of scleral fixated posterior chamber intraocular lenses (PCIOL). PATIENTS AND METHODS: Fascia lata was used to cover the knots of scleral fixated PCIOL in 5 eyes with significant scleral thinning. Four of the 5 eyes had the PCIOL insertion and the fascia lata patching in the same setting. The fifth eye previously had scleral fixated PCIOL with late suture erosion through a partial thickness scleral flap. RESULTS: There was no suture exposure or graft thinning throughout a follow-up period of 8 to 16 months. The eyes tolerated the fascia lata well with no early or late postoperative complications. CONCLUSION: Fascia lata provides an effective means to cover the knots of scleral fixated PCIOL, especially in aphakic patients with significant scleral thinning.     

Mouse mutant "rib-vertebrae" (rv): a defect in somite polarity.

The recessive mouse mutant rib-vertebrae (rv) affects the morphogenesis of the axial skeleton. The phenotype is characterized by vertebral defects such as fusion of adjacent segments, hemivertebrae, or open neural arches and rib defects including fusions, forked ribs, and additional ribs. We have analyzed this mutant in detail and are able to show that defective somite patterning underlies the vertebral malformations. The rv mutation leads to an elongation of the presomitic mesoderm and a disruption of the anterior-posterior polarization of somites, as indicated by the abnormal expression of Pax1 and Mox1. Somites are irregular in size but the overall formation of somites appears unaffected. These changes are reminiscent of somite defects obtained in loss of function alleles of the Delta-Notch pathway. Expression of the Notch pathway components Delta-like-1 (Dll1) and lunatic fringe (Lfng) are altered in rv mutants. To investigate possible interactions of rv with components of the Notch pathway, we crossed rv into Dll1(lacZ). Double heterozygous (rv/+; Dll1(lacZ)/+) mice show vertebral defects and homozygous animals with one inactive Dll1 allele (rv/rv; Dll1(lacZ)/+) exhibit a dramatic increase in phenotypic severity, indicating that rv and Dll1 genetically interact. We have mapped rv to a region on chromosome 7 that is syntenic to human chromosomes 11p, 10q, and 11p. rv is phenotypically similar to human vertebral malformations syndromes and can serve as a model for these conditions.     

Douleur, stratégies d’ajustement et détresse psychologique. Analyse complémentaire sur la validité française du coping strategies questionnaire

Coping strategies implemented by chronic pain patients play an important part in their biopsychosocial experience of life. This research aimed to confirm the validity of a coping scale and evaluate the role of different coping strategies in patient adjustment to intensity of pain and psychological distress. One hundred and thirty patients from the Pain Center of the University Hospital of ‘La Timone’ (Marseille) completed a questionnaire including the Coping Strategies Questionnaire (CSQ), the Hospital Anxiety and Depression Scale and some questions concerning the intensity of their pain. Results confirm the psychometric values of the French version of the CSQ. Several dimensions of the CSQ predict the general level of pain, anxiety and depression. Taking into account these strategies is a fruitful approach to describing the complexity of the pain experience and to thinking about how to deal with pain.     

Analyse des représentations sociales du cancer et de la souffrance

Social psychology makes it possible to link individual and social interpretations of the suffering associated with the experience of cancer. The aim of this field of psychology is to offer a branch of research that focuses on studying the potential impact of the meanings associated with cancer and societal models of coping. The psychosocial analysis of the links between suffering and cancer underlines the role of the collective experience in creating meaning with respect to suffering as well as the role of social imagery in the development of individual behaviour. This kind of analysis makes it possible to understand a significant number of the issues associated with therapeutic interaction.     

Severe hyponatremia associated with transcervical resection of a uterine myoma

Purpose

Sever hyponatremia is associated with a high mortality rate. It can occur during procedures requiring irrigation with a glycine solution.

Clinical features

A 31-year old female patient underwent transcervical resection of a uterine myoma under general anesthesia. 35 minutes into surgery, a 41 min^?1 bradycardia with hypertension (150/86 mmHg) was observed, followed by a 50 cmH₂O increase in airway pressure and an expired CO₂ of 49 mmHg, a sodium of 100 mmoles L^?1 and a negative irrigation fluid water balance of 3000 mL. After administering 600 mL of 3% hypertonic saline, 60 mg of furosemide, performing a transvaginal puncture to release the extravased fluid in the peritoneal cavity, and artificial ventilation for 6 h, positive outcome was finally achieved.

Conclusions

The resorption syndrome during transcervical resection of a uterine myoma is linked to the passage into the blood of the irrigation fluid that contains glycine. The symptoms are hidden during general anesthesia and severe hyponatremia can occur before the syndrome is detected.     

Cocaine induces the expression of homer 1b/c, homer 3a/b, and hsp 27 proteins in rat cerebellum

The long homer proteins 1b/c, 2a/b, and 3a/b play an important role in postsynaptic neurons by clustering glutamate receptors and by coupling the receptors with various intracellular effectors. Using immunohistochemistry and Western-blot analysis, this study shows that the expression of the long homer isoforms 1b/c and 3a/b was induced in rat cerebellum in response to cocaine administration. Acute treatment produced a very robust induction of both constitutive isoforms, whereas repeated treatment for 10 days induced a large expression of homer 1b/c and a more modest increase in the expression of the 3a/b isoform. The heat shock protein hsp 27 was also considerably induced in the cerebellum of cocaine-treated rats, suggesting that it participates in assisting the correct folding of proteins, and by counteracting oxidative stress mechanisms triggered by the psychostimulant. In addition of being expressed in Purkinje neurons, homer 3a/b and hsp 27, but not homer 1b/c, were localized within Bergmann glial cells and in their extensions, which surround Purkinje cells, as assessed by coimmunoreactivity with glial fibrillary acidic protein. Cocaine was also found to induce both proteins in the Bergmann glial cells. Since we found that homer 3a/b colocalized with the mGluR1 receptor in Purkinje cells, the data suggest that the long homer isoforms are involved in the cocaine-induced neuroplasticity that takes place in the cerebellum, by reshaping postsynaptic densities in Purkinje cell dendrites.     

A case of thyroid hormone resistance: Prospective follow-up during pregnancy and obstetric outcome

We describe the case of a patient with resistance to thyroid hormone (R243W substitution) and her obstetric outcome. The patient gave birth to a healthy girl, unaffected by the R243W mutation. Two years later, following an uneventful pregnancy, a baby boy was born at term; he presented the same thyroid hormone receptor mutation as his mother. Follow-up of gestational thyroid hormone levels is reported during both pregnancies and related to obstetric outcome.