The aqueous humor dynamics and the biphasic response in intraocular pressure induced by guanethidine and adrenaline in the glaucomatous eye

Continuous administration of guanethidine (3%) and adrenaline (0.5%) in one eyedrop (GA) induced a biphasic response of intraocular pressure (IOP). In ten patients with primary open angle and seven glaucoma suspects treated with (GA) twice daily during a 7 month period, tonography, and tonometry were performed and the pupil diameter measured 3 and 8 h post-GA. The combined data of both groups in the hypertensive phase, showed an IOP increase of 2.8 mm Hg (P<0.05), an unchanged coefficient of the outflow, dilated pupil (1.73 mm) (P<0.005) and a 36% increase of aqueous humor production (P<0.02). The specific biphasic course of IOP during treatment with GA seems to be caused by fluctuations in aqueous humor production. The increase in aqueous rate during the hypertensive phase could be related to secondary (rebound) vasodilation in the ciliary body and/or to a transient disruption of the blood-aqueous barrier induced by release of prostaglandins.     

Stent-graft treatment of extracranial carotid and vertebral arterial lesions

Five patients with pseudoaneurysms of the carotid artery (n = 4) and an arteriovenous fistula of the vertebral artery (n = 1) were treated with stent-grafts. Commercially made devices were used in all but one of the patients. In four of the five patients, the pathology was successfully excluded. One patient had a small type-I endoleak. There were no immediate procedure-related complications or neurologic sequalae. All experienced immediate resolution of symptoms. One patient was lost to follow-up after discharge and another died 2 weeks after intervention. The remaining patients remained asymptomatic with patent stent-grafts after follow-up periods of 14, 16, and 46 months, respectively.     

TIPS reduction with use of stents or stent-grafts

This report describes new techniques to perform TIPS reduction in patients with post-TIPS complications. Methods included hourglass-shaped stents and stent-grafts, and parallel stents and stent-grafts. All procedures were technically successful, resulting in increased portosystemic gradients and decreased symptoms, although patient outcomes were mixed. None of the patients experienced recurrent variceal hemorrhage or ascites in short-term follow-up. Stent-grafts have the advantage of immediate exclusion of blood flow outside the reducing stent, resulting in an immediate reduction of the caliber of the shunt. Techniques that allow fine adjustment of shunt diameters may have further advantages.     

Factors Associated with State Variations in Homicide, Suicide, and Unintentional Firearm Deaths

This study examined the relationship of 16 variables with homicide, suicide, and unintentional firearm deaths. This cross-sectional analysis, using adjusted partial correlation coefficients, found that state-level firearm homicide rates significantly varied by the prevalence of firearms and by percent of the population which was African American. Whereas, state-level variations in firearm suicide mortality significantly varied by firearm prevalence, per capita alcohol consumption, percent of the population which was African American, and level of urbanization. None of the variables were significantly (p < or = .05) related to state-level variations in unintentional firearm mortality. Furthermore, state gun laws had only a limited effect on firearm-related homicide deaths. Although the current study cannot determine causation, firearm mortality in its various forms is most commonly related to the prevalence of firearms and the percent of the population that is African American.     

2001 survey of pollen in Wakayama City with a real-time pollen counter

Self-care is gradually being recognized as important in the treatment of pollinosis, based up to now on data on airborne pollen. To determine the real-time numbers of airborne pollen would be more useful in self-care, however, so we studied the usefulness of the real-time pollen counter. Between Feb. 2, 2001, and Apr. 26, 2001, 4 types of airborne pollen i.e., Japanese cedar, Japanese cypress, black alder, and beech observed in Wakayama City were counted with a Durham pollen counter and a real-time pollen counter (Yamato Manufacturing Co. Ltd.). Correlation between the 2 pollen counters was r = 0.69 for Japanese cedar in March and r = 0.89 for Japanese cypress in April. A high correlation was observed between outcomes of the 2 pollen counters. The amount of pollen from black alder and beech was less than that from Japanese cedar and cypress. Unexpected peaks were observed not related to the pollen number is apparently due to snow. We have taken measure against snow, so we concluded that the real-time pollen counter was useful in counting the amount of airborne pollen over time.     

Outcome of neonatal screening for hearing loss in neonatal intensive care unit and well-born nursery infants

A newborn hearing screening was conducted on 319 neonatal intensive care unit (NICU) and 1200 well-born nursery (WBN) infants. Mean NICU birth weight was 1997 g and mean gestational age 34 weeks. Auditory brainstem response was studied in screening in NICU infants. Otoacoustic emission (OAE) or automated auditory brainstem response (AABR) was used in primary WBN screening. All infants not bilaterally passing hearing screening before discharge were recalled for outpatient retesting. If the outcome was still failure, ABR screening was conducted. The prevalence of infants diagnosed with hearing loss was 1.1% (16 of 1519). Of these 16, 75% were from the NICU and 75% were at risk for hearing loss. Mean age at hearing loss identification was 12.9 weeks in the WBN and mean age at hearing aid fitting was 16.1 weeks. Mean age at hearing aid fitting was lower for WBN than for NICU infants. Hearing loss identification and hearing aid fitting are thus feasible in NICU and WBN infants in universal newborn hearing screening.