Micropulse diode laser photocoagulation for central serous chorio-retinopathy

Purpose:  Central serous chorioretinopathy (CSC) is usually characterized by a localized detachment of the neurosensory retina that is self-limiting. However, some cases may persist or recur leading to degenerative changes of the retinal pigment epithelium and the neurosensory retina resulting in severe visual loss and requiring intervention.
Methods:  This retrospective case series reports the long-term visual outcome of the use of micropulse laser photocoagulation for this condition with a review of literature.
Results:  The mean follow up was 17.1 months. Four of the five patients had complete resolution of symptoms whereas one patient had recurrent CSC from a new leak that failed to resolve after repeat micropulse treatment despite improvement in symptoms.
Discussion:  The outcomes in this case series confirm the long-term efficacy of micropulse laser in the management of CSC. It produces therapeutic effects that appear comparable to those of conventional photocoagulation with no detectable signs of laser-induced iatrogenic damage.     

Bowman-Birk inhibitor suppresses production of superoxide anion radicals in differentiated HL-60 cells.

The Bowman-Birk protease inhibitor (BBI) is a soybean-derived protease inhibitor with anticarcinogenic and anti-inflammatory properties. BBI has previously been shown to suppress the release of superoxide anion radicals from purified polymorphonuclear leukocytes. In the present study we evaluated the effect of BBI on the production of superoxide anion radicals in differentiated HL-60 cells. HL-60 cells are human lymphocytic cells that acquire neutrophil-like characteristics when treated with dimethyl sulfoxide or tetradecanoyl phorbol acetate. Superoxide anion radical production by differentiated HL-60 cells was measured in the presence of various concentrations of BBI or BBI concentrate, a soybean extract containing high levels of BBI. BBI was observed to suppress superoxide anion radical production by differentiated HL-60 cells in a dose-dependent manner. Extracts of differentiated HL-60 cells were also observed to produce superoxide anion radicals, but this activity was not affected by the presence of BBI. These results suggest that BBI inhibits superoxide anion radical generation in HL-60 cells but does not act as a simple free radical scavenger.     

The impact of commercial human infant formula on fecal attributes in a weanling pig model.

An experiment to assess the influence of commercially available infant formulas on characteristics of feces in a weanling piglet model was conducted. Seven commercial infant formulas [whey, whey+alpha-lactalbumin, whey+alpha-lactalbumin+oligofructose, whey+GOS+polyfructose, whey protein concentrate 1 (with 27.3% acid hydrolyzed fat), whey protein concentrate 2 (with 29.4% acid hydrolyzed fat), and enzymatically hydrolyzed whey protein concentrate] were offered to weanling piglets ad libitum for 14d. Fecal attributes that were assessed include: consistency, color, odor, dry matter, organic matter, pH, biogenic amines, short- and branched-chain fatty acids, phenols, indoles, and ammonia. Overall, there were very few differences among treatment groups in fecal attributes assessed. Minor differences in the concentrations of fecal acetate, valerate, putrescine, and cadaverine were observed in piglets fed GOS+polyfructose-containing formula. However, stool consistency, score, odor, pH, ammonia, phenols, and indoles were similar among treatment groups. Diet had an effect on fecal dry matter percentage, organic matter percentage, color, and 4 week body weights of the piglets. The results obtained in this experiment demonstrate that healthy gut function is prevalent in weanling piglets consuming the experimental treatments.     

Epidural gas: an unusual complication of metastatic oesophageal carcinoma

Summary Epidural gas occurring in benign disease is well documented. Gas formation within an epidural metastasis, which has not been previously reported, was demonstrated using computed myelography.     

Use of the timeout procedure in a child psychiatry inpatient milieu: Combining dynamic and behavioral approaches

An observational study of naturally-occurring timeouts was conducted in a child psychiatry inpatient milieu over a three-month period. Data from nine children were assessed. Child negative behavior was generally low in the timeout, processing, and return to activity phases. Results from individuals were discussed in terms of their diagnosis and events taking place on the unit. Staff behavior during timeouts were also described. The crucial role of processing after the timeout was discussed.     

Topical bupivacaine and etidocaine analgesia following fallopian tube banding

The purpose of this study was to compare the effectiveness and safety of etidocaine and bupivacaine for postoperative analgesia after laparoscope sterilization. The study was performed in 22 healthy patients who received either one per cent etidocaine, 2 mg.kg-1, or bupivacaine 1.5 mg.kg-1 in a double-blind, randomized fashion. The local anaesthetic was dropped onto the fallopian tubes from uterus to fimbriae before tubal occlusion. To establish safety, blood concentrations of the parent drug and its metabolites were measured before application and at 1, 3, 6, 10, 15, 30, 60 and 120 min. The mean peak concentrations were 501.8 +/- 71.3 (SEM) for etidocaine with a range of 225 to 905 ng.ml-1. For bupivacaine, the mean peak concentration was 468 +/- 73.8 SEM with a range from 191 to 1005 ng.ml-1. The mean values are one eighth of the toxic convulsive dose for humans. Etidocaine was metabolized at a faster rate than bupivacaine with a rapid appearance of 2-amino-2'-butyroxylidide (ABX). The bupivacaine metabolite 2,6-pipecoloxylidide (PPX) was detected in low concentrations in the 60-minute samples. We conclude that the topical application of either etidocaine or bupivacaine is a safe procedure in the doses and concentrations used during general anaesthesia for laparoscopic tubal banding.     

Microcytosis in Hodgkin disease associated with unbalanced globin chain synthesis

A review of 162 patients with Hodgkin disease disclosed 36 with microcytic anemia (mean corpuscular hemoglobin values [MCV] less than 80 fl). Three patients had iron deficiency, and one had beta-thalassemia. Of the remaining 32 patients, 24 had microcytic anemia at the time of diagnosis of Hodgkin disease, and ten, including two patients with this finding initially, developed microcytic anemia in association with recurrence of Hodgkin disease. Seven patients with Hodgkin disease and normal MCV had normal alpha-to-beta-globin chain ratios (1.0 +/- 0.14). Seven patients with Hodgkin disease and MCV less than 80 fl had significantly lower alpha-to-beta chain ratios (0.66 +/- 0.05). Twelve normal controls and four with iron-deficiency anemia and MCV less than 80 fl had normal ratios. Anemia was corrected, and MCV returned to normal in all patients who responded to therapy for Hodgkin disease. In the two patients studied sequentially, abnormal alpha-to-beta-chain ratio was corrected along with the anemia.