Reversible mydriasis and cycloplegia after isocyanate exposure]

We saw three patients working in the production of polyurethanes, who showed mydriasis and cycloplegia of unknown origin. In one patient there was also a transient opacification of corneal stroma. After discontinuation of working both mydriasis and cycloplegia resolved completely within 3-5 days. Because of the history and the analysis of chemical reactions involved in the production of polyurethanes there is strong evidence that both mydriasis and cycloplegia have been caused by topical and (/or) systemic intoxication with the aryl diet of the isocyanate molecule.     

Nonsurgical treatment of childhood hypertension: Embolization of an intrarenal aneurysm

Renal artery aneurysms are an unusual cause of renovascular hypertension in children. When present in an intrarenal location, they pose a difficult surgical problem and transcatheter embolization may represent an effective alternative treatment.     

Einfluss der transrektalen Endosonographie auf die klinische Stadieneinteilung des nicht palpablen Prostatakarzinoms

Since 1992, the TNM system has classified impalpable prostate cancers with visible lesions on imaging as clinical stage T2. Due to controversial reports in the literature, this classification has not been well accepted in clinical practice. Most urologists consider all impalpable prostate cancers irrespective of their imaging as T1c. Transrectal ultrasound (TRUS) is the imaging tool most frequently used for diagnostic purposes in prostatic diseases. In our study, we compared prognostic cancer characteristics and the likelihood of biochemical cure between impalpable tumors invisible on TRUS and those visible. Identical comparisons were performed between impalpable, but visible prostate cancers and palpable T2a tumors. Patients with impalpable and invisible prostate cancers showed the most favorable cancer characteristics. Impalpable, but visible prostate cancers differed in their prognostic parameters from those invisible. These differences were more pronounced when compared to palpable T2a tumors. The probability of biochemical cure was comparable in both groups of impalpable cancers. However, impalpable tumors visible on TRUS exhibited a significantly more favorable outcome than T2a cancers. Consequently, impalpable prostate cancers should be classified as T1c regardless of their visibility on TRUS.     

Polyphenols: food sources and bioavailability

Polyphenols are abundant micronutrients in our diet, and evidence for their role in the prevention of degenerative diseases such as cancer and cardiovascular diseases is emerging. The health effects of polyphenols depend on the amount consumed and on their bioavailability. In this article, the nature and contents of the various polyphenols present in food sources and the influence of agricultural practices and industrial processes are reviewed. Estimates of dietary intakes are given for each class of polyphenols. The bioavailability of polyphenols is also reviewed, with particular focus on intestinal absorption and the influence of chemical structure (eg, glycosylation, esterification, and polymerization), food matrix, and excretion back into the intestinal lumen. Information on the role of microflora in the catabolism of polyphenols and the production of some active metabolites is presented. Mechanisms of intestinal and hepatic conjugation (methylation, glucuronidation, sulfation), plasma transport, and elimination in bile and urine are also described. Pharmacokinetic data for the various polyphenols are compared. Studies on the identification of circulating metabolites, cellular uptake, intracellular metabolism with possible deconjugation, biological properties of the conjugated metabolites, and specific accumulation in some target tissues are discussed. Finally, bioavailability appears to differ greatly between the various polyphenols, and the most abundant polyphenols in our diet are not necessarily those that have the best bioavailability profile. A thorough knowledge of the bioavailability of the hundreds of dietary polyphenols will help us to identify those that are most likely to exert protective health effects.     

Pigment epithelium endoscopic laser surgery for treatment of choroidal neovascularization

PURPOSE: To present a new concept and technique for subretinal surgery. METHODS: Twenty-four eyes of 24 patients with subfoveal choroidal neovascularization (CNV) were included in this study. Nine patients were operated on in Mexico City by one surgeon, 15 patients in Frankfurt by another surgeon. The retina at the posterior pole was detached and subretinal thermal photocoagulation of the CNVs was performed using a 20/19-gauge GRIN rod laser endoscope (Insight Instruments Inc., Sanford, Fla., USA). This procedure was termed PEELS (pigment epithelium endoscopic laser surgery). RESULTS: In 7 patients (Mexico), moderate improvement or stabilization of vision over 6 months or longer was achieved. In 10 out of 12 patients (Frankfurt), stabilization of vision over a follow-up period of 6-18 months was achieved, at least. Serious complications were not observed. Four of the Frankfurt series patients improved their vision. CONCLUSION: PEELS can stabilize or improve vision.