Ultrasonic findings in the vitreous space in patients with detachment of the retina

Summary Ultrasonic observations were made of the vitreous body and the subretinal space of the sick eye and of the vitreous body of the other eye on 32 unselected subjects with idiopathic detachment of the retina. In almost all sick eyes a severe state of degeneration of the vitreous body was observed, and in all cases examined the subretinal space was acoustically heterogeneous.In the other eye degeneration of the vitreous body was often observed, although to a lesser degree than in the eye with retinal detachment. The ultrasonic examination of the vitreous body may yield information as to the disposition of the eye with regard to detachment of the retina.

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Zusammenfassung Bei 32 nicht ausgewählten Patienten, die an einseitiger idiopathischer Netzhautablösung litten, wurden mit Ultraschall der Glaskörper und Subretinalraum des Ablösungsauges sowie der Glaskörper des andern Auges untersucht. In allen an Netzhautablösung leidenden Augen wurde deutliche Degeneration, d.h. Synärese des Glaskörpers festgestellt, und der Subretinalraum war in allen untersuchten Fällen akustisch heterogen.In dem anderen Auge stieß man oft auf Glaskörperdegeneration, die jedoch geringer war als im Ablösungsauge. Die Ultraschalluntersuchung des Glaskörpers kann uns Kenntnis von der Disposition des Auges für Netzhautablösung vermitteln.

     

Oligoclonal Peyer's patch follicles in the terminal small intestine of cattle

In small ruminants, the development of B cells differs from that in mice or in man. The anti-body repertoire is expanded in the Peyer's patches of the terminal ileum where each B-cell follicle is found by a few cells. To investigate the amount of founder clones in bovine ileal follicles, we have used sex mismatched cattle twins. These animals are chimeric due to placental anastomoses. Y-chromosome targeted in situ hybridization was used to trace donor-derived cells of the male genotype in a female recipient (called a freemartin). A strong clustering of lymphoid cells originating from either twin was seen in the ileal Peyer's patches (IPPs). Furthermore, the follicles displayed a low amount of immunoglobulin heavy chain gene configurations in comparison with the splenic or jejunal follicles. These findings strongly suggest that as in sheep, the B-cell follicles in cattle IPPs develop oligoclonally.     

Acute Respiratory Failure during Routine Blood Transfusion: A Case Report and Review of the Literature

Background

Transfusion medicine is a common practice in the emergency department (ED) and other outpatient settings, and may be complicated by a low rate of potentially fatal transfusion-related reactions.

Objectives

This article presents a case of transfusion-related acute lung injury (TRALI) diagnosed and treated in the ED and reviews the differential diagnosis of acute transfusion reactions.

Case Report

A 74-year-old woman presented to the ED from the hospital's transfusion center with fever and respiratory distress immediately after the start of her second unit of red blood cell transfusion. Chest radiograph demonstrated a pattern consistent with acute respiratory distress syndrome (ARDS). After 48 h of respiratory support and antibiotic therapy, the patient's condition improved.

Conclusion

TRALI is a clinical diagnosis with presentation similar to that of ARDS. Prompt differentiation from other transfusion reactions and initiation of appropriate treatment is crucial in minimizing the morbidity and mortality associated with this syndrome.     

Ultrasonic findings in the vitreous body in patients with acute anterior uveitis

The vitreous body of both the healthy and the affected eyes of 25 patients suffering from unilateral acute anterior uveitis was examined by ultrasound, and the results were compared with the optical observations made on the affected eye. In 14 eyes the optical examination of the vitreous body was impossible either due to exudation in the anterior chamber or to posterior synechias of the iris or to cataract. In 17 eyes the vitreous body was acoustically highly inhomogeneous, in three eyes slightly inhomogeneous and in five eyes no acoustic changes due to exudation were found. In cases of acute anterior uveitis, ultrasound examination often provides more information than optical examination by slit lamp. Ultrasound can also be useful in the treatment and follow-up of the disease.     

Expression of sterol regulatory element-binding transcription factor (SREBF) 2 and SREBF cleavage-activating protein (SCAP) in human atheroma and the association of their allelic variants with sudden cardiac death

Background

Venous thromboembolism (VTE) and thromboembolic arterial diseases are usually considered to be distinct entities, but there is evidence to suggest that these disorders may be linked. The aim of this study was to determine whether a diagnosis of VTE increases the long-term risk of myocardial infarction (MI).

Methods

The incidence rate (IR) and relative risk (RR) of MI in a cohort of patients with a diagnosis of VTE (n = 4890) compared with that of a control cohort without prior VTE (n = 43 382) were evaluated in the UK General Practice Research Database (GPRD). Death during follow-up was also determined. Patients were followed for up to 8 years (mean of 3 years).

Results

The IR of MI per 1000 person-years was 4.1 (95% CI: 3.1–5.3) for the VTE cohort and 3.5 (95% CI: 3.2–3.8) for the control cohort. The IR of MI was highest in the first year after the VTE episode, but overall differences between the two cohorts were not significant (RR of MI associated with VTE: 1.2; 95% CI: 0.9–1.6). The risk of death was higher in the VTE cohort than the control cohort, even after adjustment for cancer, heart failure and ischaemic heart disease (RR: 2.4; 95% CI: 2.2–2.6), particularly during the first year after VTE (RR: 3.8; 95% CI: 3.4–4.3).

Conclusion

A VTE episode does not significantly increase the risk of MI, but does increase the risk of death, particularly in the first year following VTE diagnosis.     

Comparison of nitric oxide donors in lowering intraocular pressure in rabbits: role of cyclic GMP.

L-arginine-nitric oxide (NO) pathway participates in the physiology and in many pathological processes in the eye, such as glaucoma. The aim of the present study was to compare the ocular hypotensive effect of different NO-donors, and to get more information on the role of cyclic guanosine 3',5'-monophosphate (cGMP) in this process. The test compounds were administered topically or intravitreally in the eye of a normotensive rabbit. Intraocular pressure (IOP) was measured with a pneumatonometer after topical anesthesia. The metabolites of NO (nitrite, nitrate, NOx) and cGMP were assayed from the aqueous humor and plasma. NO-synthase (NOS) protein expression was assayed in the ciliary body by Western blotting. The maximal lowering of IOP was achieved as follows: atriopeptin III (concentration 78 (microM, decrease in IOP 50%), atriopeptin II (84 (microM 37%). 8-Br-cGMP (90 mM, 37%), zaprinast + 8-Br-cGMP (1 mM + 90 mM, 34%), L-arginine (1 mM, 29%), SNP (40 mM, 28%), nitrosocaptopril (100 mM, 28%), S-nitrosothiol (SNOG) (10 mM, 27%), YC-1 (10 (microM, 25%), zaprinast + SNP (1 mM + 40 mM, 22%), spermine NONOate (100 mM, 20%) [corrected]. The decrease in IOP lasted for 2-5 hr, except with atriopeptin II and III, when IOP values were first normalized in 6 hr and 2 days, respectively. In conclusion, the results of the present study indicate that by increasing the activity of L-arginine/NO/cGMP-pathway it is possible to lower IOP in rabbits equally to the currently used antiglaucomatous drugs.     

Choroidal detachment associated with scleritis--a case report with echograms

The case presented is an 80-year-old woman who has suffered from scleritis in her right eye four times during the last 10 years. A week after the patient was taken ill for the fifth time with severe scleritis in her right eye, a dark and extensive, several millimeters high, circumferential protrusion was observed in the periphery of the fundus. An optic examination presented difficulties in differential diagnosis in relation to a melanoma, while a diascleral illumination brought out information against the possibility of a melanoma. At an ultrasonic examination the detachment itself reflected high echoes, as opposed to the low echoes obtained from the space under the detachment. The ultrasonic examination pointed to an exudative detachment of the choroid. After a week's treatment with mydriatics and steroids the choroidal detachment had disappeared completely.