Ocular blood flow and choroidal thickness in ocular hypertension

International Ophthalmology - Ocular hypertension (OHT) is a clinical entity characterized by elevated intraocular pressure (IOP) without optic nerve damage. In the presence of other risk factors,...     

Influence of scan radius correction for ocular magnification and relationship between scan radius with retinal nerve fiber layer thickness measured by optical coherence tomography.

PURPOSE: To investigate how optical coherence tomography (OCT) modifies the preset scan parameters to correct the errors resulting from ocular magnification, the influence of examiner's final correction of those already modified parameters on retinal nerve fiber layer (RNFL) thickness measurements, the induced change on RNFL thickness measurements and RNFL estimated integrals (RNFL(estimated integrals)) by adjusting the actual scan radius during RNFL examinations performed by OCT. METHODS: Thirty-five healthy patients underwent an RNFL examination by OCT four times using different scan radii. The first scan was performed with the preset circular scan diameter of 3.46 mm; the actual scan diameter was different, however, because it was modified by the OCT instrument. The second, third, and fourth scans were generated after readjusting the already modified scan diameter by the examiner to 3.46, 3.20, and 3.60 mm. The relationship of axial length and refractive error with the actual scan radius (with ocular magnification calculated by OCT), with the influence of the examiner's final correction on RNFL thickness measurements, with the relationship between scan radius with RNFL thickness measurements, and with RNFL(estimated integrals) were investigated. RESULTS: The actual scan diameter was found to be primarily determined by axial length (R = 0.97, P < 0.0001), but the influence of refractive error was small (R = -0.26, P = 0.067). Final correction of the actual scan radius by the examiner had a significant influence on RNFL thickness measurements (P = 0.025). RNFL thickness measurements obtained without correction of the actual scan radius for magnification were found to be inversely correlated with axial length (R = -0.54, P = 0.001), whereas no similar relationship was found when RNFL thickness measurements were obtained with correction (R = 0.21, P = 0.11). A reciprocal relationship between 1/scan radius with RNFL thickness measurements (they tended to be thinner as scan radii were increased) was found (R = 0.41, P = 0.169), but RNFL(estimated integrals) areas were found to be independent of the scan radius (P = 0.521). CONCLUSION: To increase the accuracy of RNFL thickness measurements, it will be appropriate for the examiner to manually correct the actual scan parameters to the desired or preset ones after their automatic modification performed by the OCT instrument. Keeping the actual scan radius constant for repeated exams is also recommended because RNFL thickness measurements were found to depend on scan size. Alternatively, RNFL(estimated integrals) could be used because they were found to be independent of the scan size.     

Granulomatous hepatitis after intravesical BCG treatment for bladder cancer.

Intravesical bacillus Calmette-Guerin (BCG) is used in patients with urinary bladder carcinoma. Although it is generally well tolerated, granulomatous hepatitis is a rare but serious complication. We report a 42-year-old man and a 56-year-old man who developed granulomatous hepatitis following intravesical BCG. One of them was treated successfully with antitubercular therapy; the other died because of BCG sepsis and multi-organ failure.     

Novel Βeta (β)-Thalassemia Mutation in Turkish Children

Beta (β)-thalassemia is the most frequently observed hereditary blood disorder in the world. It is characterized by deficiency of hemoglobin β-globin gene and is also a profoundly heterogeneous both at the molecular and clinical level. In the case of β-thalassemia, there is reduced (β⁺ type) or absent (β^o type) synthesis of the beta chains of hemoglobin. β-Thalassemia clinically occurs in three main forms: major, intermedia and minor according to requirement of transfusion. The objective of this study was to evaluate β-thalassemia mutations in 89 patients ranging from 2 months to 16 years of age, who enrolled to Medical School Research and Training Hospital, Gaziantep University. The direct DNA sequence analysis was performed for mutation scanning of β-globin gene. 89 children with β-Thalassemia including all types were analyzed, 16 different β-thalassemia mutations were detected. We have also identified a novel mutation (HBB.c.-80delT, rs397509430) in the promoter region (−30 TATA box) of β-globin gene, and clinical data of patient having novel mutation was given. The β-Thalassemia mutations were determined as β-Thalassemia major type in 42 patients (47.19 %), β-Thalassemia intermedia in 4 (4.49 %), β-Thalassemia minor in 43, (48.31 %) patients. The most frequent mutation was IVS I-110 G>A, followed by IVS I-1 G>A, IVS I-6 T>C, IVS II-1 G>A, respectively.     

Effect of constipation on serum total prostate-specific antigen levels in men

Objectives: Many factors affecting serum prostate‐specific antigen (PSA) levels have been described. The aim of this study was to examine the effect of constipation on serum PSA levels in men. Methods: Serum total PSA values were measured in 136 constipated patients before and after treatment for constipation. Moreover, they were compared with 45 control patients. Results: Serum total PSA values in the constipated patients before treatment were significantly higher than those in the control group (2.29 ± 1.29 ng/mL vs 1.28 ± 0.86 ng/mL, P < 0.0001). After the treatment of constipation, serum total PSA values in the constipated patients were still higher than those in the control group, but this difference was not statistically significant (P = 0.0871). After the treatment of constipation, prostate biopsy rates were 6.6% and 2.2% in the study and control group, respectively (P = 0.2769). No prostate cancer was found in both groups. Conclusions: Constipation increases serum PSA levels in men. The presence of constipation must be considered in patients whose PSA is examined, especially in those with PSA levels that are borderline high or in the range of 2–10 ng/mL. Constipated patients must be first treated and then re‐evaluated.     

Severe electrical injury

From January 1979 to January 1987, 125 patients were treated in our Centre for various electrical injuries. Among them, 85 patients were over 15 years of age (89.4 per cent were males and 10.6 per cent females) and 40 patients were below 15 years of age (92.5 per cent were males and 7.5 per cent females). Electricians were the most frequently injured in the over 15-year-old age-group, whereas most patients under 15 years old were students. We focused our study on five patients with multiple and severe electrical injury. Two of these patients were injured while erecting TV aerials, two were injured at work and the other one was working on a house roof. Despite all our efforts extensive limb amputations were required. Following complete healing, we fitted prostheses to the amputation stumps. All the patients have now returned to society as capable individuals, two of them to their previous occupations and the other three with new occupations. Our experience with five patients showed that patients with severe electrical injury and multiple amputations have a reasonable chance of recovery. Rehabilitation therapy must be given as early as possible after the electrical injury so that the patients may return to their normal place in society.     

The use of deferoxamine infusions to enhance the response rate to interferon-α treatment of chronic viral hepatitis B

Summary An individual's iron status may affect the response rate achieved with the use of interferon (IFN) as therapy for chronic viral hepatitis. A total of 27 patients with chronic hepatitis B viral infection, who had elevated serum ferritin levels, were randomized to receive either IFN 5 MU, three times weekly by subcutaneous injection alone ( n = 14) or in combination with cycles of deferoxamine at a dose of 80 mg kg^-1 per cycle ( n = 13) administered over 3 consecutive days, to reduce their iron and maintain a serum ferritin level less than 250 ng ml^-1. All deferoxamine-treated patients were on a low iron-containing diet. An IFN response was defined as a normalization of the serum alanine aminotransferase (ALT) level and seroconversion from hepatitis B e antigen (HBeAg) positivity to hepatitis B e antibody (HBeAb) positivity. The deferoxamine-treated group experienced a reduction in their serum ferritin level to 226 ± 73 ng ml^-1 as a result of the deferoxamine treatment. Six of the 13 (46%) deferoxamine-treated patients and two of the 14 (14%) control patients normalized their ALT levels. Seven of the 13 (54%) deferoxamine but only 14% of the IFN-treated group seroconverted to HBeAb positivity. A greater rate of histological improvement and loss of hepatitis B virus (HBV) DNA was seen in the deferoxamine-treated group. Two of the deferoxamine-treated patients were treated only once, two were treated twice, seven were treated three times and two were treated four times to achieve a ferritin level below 250 ng ml^-1.