Cystoid macular edema in anterior chamber lens implantation following posterior capsule rupture

By comparing the incidence of cystoid macular edema (CME) in three groups of patients having different surgical procedures, we attempted to assess the role of vitreous loss as a risk factor for CME development. In the first group (n = 470), the surgical procedure was extracapsular cataract extraction followed by implantation of posterior chamber lens (EC-CE + PC-IOL). The second group (n = 42) had extracapsular cataract extraction which was complicated by posterior capsule rupture, and therefore anterior vitrectomy followed by implantation of anterior chamber lens had to be performed (ECCE + anterior vitrectomy + AC-IOL). In the third group (n = 22) the surgery was intracapsular cataract extraction followed by anterior chamber lens implantation (ICCE + AC-IOL). The third group was included in this follow up study to assess the role of AC-IOL as a possible causative factor for development of CME in uncomplicated cases of ICCE and AC-IOL. The difference of incidences of CME in the second and third group would therefore depend mostly on the vitreous loss. The incidence of CME diagnosed by fluorescein angiography in the first, second and third group was 1.5% (7/470), 35.7% (15/42) and 9.0% (2/22), respectively. All patients who developed CME were treated with combination of corticosteroid-antibiotic drops, dexamethasone retrobulbarly (40 mg/day) and peroral indomethacine (25 mg/day/6 weeks). This therapeutic regime resulted in only moderate improvement of visual acuity.Abbreviations AC-IOL anterior chamber intraocular lens - CME cystoid macular edema - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - IOL intraocular lens - PC-IOL posterior chamber intraocular lens     

No interference of rheumatoid factor(s) with toxoplasmosis IgM determination in infancy

Sera from 263 newborns and infants suspected of congenital toxoplasmosis were tested for the presence of rheumatoid factor (RF) by the latex agglutination test, of which 40 were also tested by the enzyme-linked immunosorbent assay (ELISA). RF was detected in only one serum sample (0.38%), suggesting that false-positive results of the IgM-indirect fluorescent antibody test and the IgM-ELISA due to RF is most unusual in infancy.     

Prolonged T1 values of the crushed nerve are not exclusively attributable to Wallerian degeneration or endoneurial edema

Axonotmesis of the left sciatic nerve was performed on adult male Wistar rats. T1 values of the crushed nerve samples were determined with proton magnetic resonance spectroscopy. Denervation changes of the dependent hind plantar flexor muscles were assessed with proton magnetic resonance imaging of their cross-sectional area and muscle force measurements. However, Tl relaxation time of the crushed nerve samples remained prolonged implying the absence of nerve regeneration. This would be in contradiction with what is known about regeneration after simple crash and the muscle force and magnetic resonance imaging measurements of the dependent plantar flexor muscles. These studies indicated that sufficient nerve regeneration had taken place to restore their muscle force and volume. A model is suggested to explain the persistence of prolonged Tl values in the presence of muscle force recovery.     

Reproducibility of quantitative hexakis-2-methoxyisobutylisonitrile single photon emission tomography in stable coronary artery disease

The quantification of myocardial perfusion abnormalities is necessary to allow comparison of repeated studies, especially in the evaluation of the success of medical, interventional or combined treatment in stable coronary artery disease or in evolving myocardial infarction. The purpose of this study was to assess inter-observer reproducibility of tomographic study processing using a semi-automatic quantitative programme. Technetium 99m hexakis-2-methoxyisobutylisonitrile (^99mTc-Sestamibi) was chosen for tomographic imaging of repeated rest-stress studies in patients with stable coronary artery disease. The quantification was performed using a modification of the Cedars polar coding and comparison with the normal data base. The perfusion defects were quantified separately for each standard perfusion area [left anterior descending (LAD), right coronary (RCA) and left circumflex (LCX) arteries] and total area of hypoperfused myocardium. The inter-observer variability for 40 tomographic studies was accomplished. The defects were the largest in the LAD perfusion area (average 19.7% of the normalized LAD supply area) with an inter-observer correlation of 0.84 for this region. The greatest variability was found for the LCX region (r=0.55) and is attributed to a small average perfusion defect (7.1%), only 18 studies having abnormal perfusion in this area. In total, an average 14.3% of the left ventricular myocardium was significantly hypoperfused, and the inter-observer correlation was 0.87. These results show good inter-observer reproducibility using semi-automatic quantitation of perfusion defects. Careful interpretation of smaller defects in the evaluation of treatment results is advised when repeated ^99mTc-Sestamibi single photon emission tomography studies are processed by more than one observer.The work was performed at Nuclear Medicine Department in Ulm. Offprint requests to: M. Milinski     

Identification and radioimmunologic estimation of sexual steroid hormones in aqueous humor and vitreous of rabbit eye

Summary The occurrence of testosterone, estrone, and estradiol-17 in aqueous humor and vitreous body of the rabbit eye was demonstrated. The identity of the steroid hormones was confirmed by their chromatographic properties, microreactions, and radiochemically by crystallization to constant specific activity of their labeled acetates. The levels of testosterone and estrogens in rabbit male and female plasma, aqueous, and vitreous were determined by radioimmunologic assay. The concentrations of the steroid hormones in plasma are higher than in aqueous and vitreous. However, testosterone in aqueous circulates in free form and lacks the binding to sexual hormone-binding globulin as in plasma.

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Zusammenfassung Bericht über das Vorkommen von Testosteron, Oestron und Oestradiol-17 im Kammerwasser und Glasörper des Kaninchenauges. Die Art der Steroide wurde mittels Chromatographie, Mikroreaktionen und radiochemisch ermittelt. Der Testosteron- und Oestrogenspiegel im männlichen und weiblichen Kaninchenplasma, im Kammerwasser und Glaskörper wurde radioimmunologisch bestimmt. Die Plasmakonzentration der Steroidhormone lag höher als diejenige im Kammerwasser oder Glaskörper. Testosteron zirkuliert jedoch im Kammerwasser in freier Form, im Plasma dagegen ist es überwiegend an Sexualhormonebindende Globuline gebunden.

     

Platten- und Schraubenosteosynthese bei Femurschaftfrakturen Retrospektive Studie von 500 Femurschaftfrakturen

The authors collected 500 cases of breaks of the thighbone shaft which were treated using osteosynthesis with screws, between 1st January 1992 and 31st of December 1996 at the Department for Traumatology of the University Medical Center in Ljubljana. Most patients were male (70.6%), the average age was 36.6 years, and the majority of patients had been injured in traffic accidents. In 50% of cases, only the thighbone was broken, the rest had suffered multiple injuries, or were polytraumatised. Their stay in hospital averaged 17 days, while the average time to union was 21 weeks. In most cases (85%), treatment proceeded with no complications. Chronical post-traumatic osteitis occurred in 9 of the patients with open breaks (1.8%), and only in 2 patients (0.4%) with closed breaks, which is within the limits of tolerance. With respect to our experience and results with osteosynthesis with plates and screws in the thighbone shaft, we believe that the mentioned method is good and gives results which are comparable to those achieved using other methods.     

Hemangiomas of the external auditory canal:a literature review and two new case reports

Aim  

The aim of this paper is to present two case reports of patients with hemangiomas of the external auditory canal, and to overview all cases published in English language literature so far.     

Ontogenetic influence on rat susceptibility to lindane seizure after pretreatment with phencyclidine

The aim of the study was to determine the effects of early postnatal PCP treatment on the sensitivity of pubertal and adult rats to lindane proepileptogenic effects. Rat pups were treated with NaCl (0.9%) or PCP (10 mg/kg) at postnatal days 2, 6, 9 and 12. One control (NaCl-35) and one experimental (PCP-35) group have received lindane (4 mg/kg) at postnatal day 35, while others received lindane at postnatal day 65 (NaCl-65 and PCP-65). One week prior to lindane treatment three gold-plated EEG electrodes were implanted. Pubertal rats had significantly shorter latency time. After lindane, a prompt increase in power spectral density seen in PCP-treated groups vs. control was evident earlier in PCP-65 rats. The theta waves were significantly increased in PCP-35 and alpha rhythm in PCP-65 rats, when compared with corresponding controls. Postnatal PCP treatment increases the synchronization of brain electrical activity, thus contributing to the increased susceptibility to lindane.     

The knowledge about autonomic dysreflexia among nursing and physiotherapy students

Context/Objective Autonomic dysreflexia is a clinical syndrome affecting persons with spinal cord lesions. The aim of the study was to detect the level of knowledge among students about autonomic dysreflexia in persons with spinal cord lesions.

Design: Single centre questionnaire study.

Setting: Faculty of Health Studies, Rijeka, Croatia.

Participants Nursing (n?=?43) and physiotherapy (n?=?48) students.

Outcome Measures: AD knowledge test.

Results: More of the half of the students (57%) had contact with persons with spinal cord lesions during work, especially nursing students. The self-estimated knowledge of autonomic dysreflexia was judged as poor or none in 73.6% of students. On the autonomic dysreflexia knowledge test, nursing students collected mean of 5.6 points and physiotherapy students 4.9 points (P?=?0.173). There was no difference in the autonomic dysreflexia test results regardless of work experience or group affiliation.

Conclusion: The level of knowledge about autonomic dysreflexia among students was low. Our results suggest the need for more education of students and health care professionals to apply adequate treatment to persons with episodes of autonomic dysreflexia.