Magnetic resonance imaging and Orbscan assessment of the anterior chamber

PURPOSE: To evaluate the correlation between white-to-white (WTW) distance as assessed by Orbscan II (Bausch & Lomb) and high-resolution magnetic resonance imaging (MRI) sulcus-sulcus (S-S) measures and to analyze the correlation between age and anterior chamber parameters. SETTING: Istituto per la Ricerca e la Cura del Cancro, Candiolo, Torino, Italy. METHODS: Eighty-eight patients had MRI with a 1.5 Tesla imager (GE Medical Systems) using a 3-inch circular coil. T1 weighted fast spin-echo scans were performed on the axial plane. Orbscan II was also used to measure WTW distance, K, anterior chamber depth (ACD), and lens curvature. One eye was randomly selected for analysis. Measures were compared using Spearman correlation, paired Student t test, and analysis of variance (ANOVA; post hoc: Scheffé). Intersession variability was performed in 10 patients. Ten MRI images were randomly selected and measured by 2 operators in a masked fashion (intrasession variability). RESULTS: Intersession and intrasession correlation was good for MRI (r = 0.89 and r = 0.92, respectively), and intersession was good for Orbscan (r = 0.91). When comparing Orbscan II and MRI results, the ACD was well correlated and not significantly different, whereas the S-S and the WTW measures were not correlated and significantly different. Lens thickness and lens diameter were directly correlated with age; S-S, WTW, lens curvature, and ACD were inversely correlated with age. CONCLUSIONS: Current methods of measuring the WTW were poorly correlated with anatomical measures. The S-S diameter and other anterior chamber structures significantly change with age, which could give rise to potential problems with posterior chamber phakic intraocular lens sizing position.     

The long-term effectiveness of generic adult fixed-dose combination antiretroviral therapy for HIV-infected Ugandan children

Background

Access to pediatric antiretroviral formulations is increasing in resource-limited countries, however adult FDCs are still commonly used by antiretroviral therapy (ART) programs.

Objective

To describe long-term effectiveness of using adult FDC of d4T+3TC+NVP (Triomune) in children for HIV treatment.

Methods

Clinical, immunologic, and virologic outcomes of HIV-infected ART-naïve children aged six months to 12 years, were evaluated up to 96 weeks post-ART initiation.

Results

From March 2004 to June 2006, 104 children were followed with a median age of 5.4 years, median CD4 cell percent and HIV-1 RNA were 11.0% (IQR 6.7–13.9) and 348,846copies/mL (IQR 160,941–681,313) respectively at baseline. Using Kaplan-Meir estimates, 75% of children had undetectable viral loads (<400copies/mL) at 96weeks of ART. Children with a baseline CD4 cell percent >15% were 3 times more likely to achieve viral load <400copies/mL than those with baseline CD4 cell percent <5% after adjusting for baseline age {aHR = 3.03 (1.10–8.32), p=0.03}; no difference was found among those with CD4 cell percent >5–14.9% and <5%.

Conclusion

Treatment with generic adult FDC for HIV-infected Ugandan children led to sustained clinical, immunologic and virologic response during 96 weeks of ART. Early initiation of ART is key to achieving virological success.     

Wirkungen niedriger Kohlenmonoxid-Konzentrationen auf die Flimmerverschmelzungsfrequenz und das subjektive Befinden des Menschen

Summary The contradictory results found in the literature on the effects of carbon monoxide (CO) led us to the hypothesis that results could depend on the degree of activation of the subjects, i.e. on the corresponding experimental conditions. For that purpose we examined the effects of low CO exposures on the critical flicker fusion frequency (CFF) and the assessment of the subjective condition in a monotonous as well as in an activating situation.20 healthy non-smokers were examined in a climatized chamber. In a first part, 10 subjects participated in a monotonous and an activating session each, with as well as without CO exposures. In the second part, the experiment was completed with another 10 subjects, whereby the monotonous situation only was applied. The CO concentration in the climatized chamber amounted to 150 ppm, which resulted in a carboxyhemoglobin level of 9 – 11% at the end of the sessions (i.e. after 3 1/2 hrs). The monotonous situation was characterized by a uniform repetitive activity (counting nails during 3 hrs in a given beat). In the activating situation, the subjects had to carry out a series of psychomotor tests, whereby they could listen to music in the intervals. The CFF was measured at the beginning of each session and again after each subsequent hour. The assessment of the subjective condition was recorded at the beginning as well as at the end of the sessions, and, for 10 persons, after the second hour of each session by means of 2 questionnaires.Results: The monotonous situation caused a mean decrease of the CFF of 1,8 Hz between the beginning and the end of the session, as well as a significant desactivation of the subjective feelings. The activating situation did not influence the CFF nor the subjective condition.

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Wir danken der Association Suisse des Fabricants de Cigarettes (ASFC) für die gewährte Unterstützung des vorliegenden Forschungsprojekts.     

NK and NKT-like cells in granulomatous and fibrotic lung diseases

Clinical and Experimental Medicine - Background The pathogenetic and regulatory roles of natural killer (NK) and natural killer T-like cells in interstitial lung diseases (ILDs), fibrotic and...     

Neuroendocrine carcinoma arising within a retroperitoneal mature teratoma

We discuss an unusual case of a large cystic mass arising in the left upper quadrant of a 48-year-old woman. Radiological investigations could not confirm the origin or the nature of the mass. A laparatomy revealed a large retroperitoneal cystic mass sandwiched between the left adrenal, spleen and the gastro-oesophageal junction. Histological analysis confirmed a mature teratoma of the retroperitoneum with neuroendocrine carcinoma arising within it. To our knowledge this is only the second reported case of its kind.