Non-arteritic Anterior Ischaemic Optic Neuropathy after Uneventful Cataract Extraction

We present the case of a 74-year-old Caucasian female who suffered sudden visual loss after routine phacoemulsification cataract surgery. The patient was subsequently diagnosed with non-arteritic anterior ischaemic optic neuropathy. The case is described in detail, and a concise review of the literature is presented together with the authors’ view on the subject outlined. This is a very rare complication after cataract surgery even in high-risk patients with associated systemic co-morbidities. We suspect that the previous history of obesity, coronary artery disease, and arteriosclerosis contributed to the development of this serious ocular complication. We suggest appropriate measures to reduce the risk of its occurrence.     

Complete hepatic venous isolation and extracorporeal chemofiltration as treatment for human hepatocellular carcinoma: A phase I study

Background: We performed a phase I study of a novel system of complete hepatic venous isolation and extracorporeal chemofiltration in patients with unresectable hepatocellular carcinoma (HCC) to determine (a) whether systemic exposure to doxorubicin could be limited after high-dose hepatic arterial infusion (HAI), and (b) the hepatic maximum tolerated dose (MTD) of doxorubicin. Methods: Ten patients with biopsy-proven HCC were treated with 20-min HAI of doxorubicin (17 total treatments). Two patients were treated with doxorubicin 60 mg/m², three patients were treated at 90 mg/m², and five patients received 120 mg/m². A newly developed dual-balloon vena cava catheter was advanced from the femoral vein, and the balloons were inflated to isolate and capture total hepatic venous outflow. The hepatic venous blood was pumped through extracorporeal carbon chemofilters before return of the blood to the systemic circulation. Results: Peak systemic doxorubicin levels were an average 85.6% lower than were peak prefilter levels (p<0.01). Because all catheters were placed percutaneously and because the chemofiltration markedly limited systemic chemotherapy exposure, patients were discharged 1 day after 16 of the 17 treatments. The hepatic and systemic MTD of doxorubicin in this treatment protocol was 120 mg/m². Conclusions: This novel system of complete hepatic venous isolation and chemofiltration limits systemic chemotherapy toxicity and will allow use of higher doses of chemotherapeutic agents to treat HCC. The results of this study were presented at the 46th Annual Cancer Symposium of The Society of Surgical Oncology, Los Angeles, California, March 18–21, 1993.     

Recognition of a novel naturally processed, A2 restricted, HCV-NS4 epitope triggers IFN-gamma release in absence of detectable cytopathicity

Using short term CTL lines derived from HLA A2/K^b transgenic mice and IFN-gamma release assays we demonstrate that the NS4.1769 epitope, is generated from natural processing of the NS4 antigen, and presented in the context of the A2/K^b molecules. Interestingly, T cell recognition of the naturally processed form of the NS4.1769 epitope was associated with significant IFN-gamma release, but no direct cytolytic activity. Epitopes of this phenotype might be of interest, in terms of therapy of chronic HCV infection by associating the benefit of localized lymphokine release with low or absent direct cytopathicity.     

Photo-reflex-rheographical method in the evaluation of elastocompression

The importance of a "compression-mobilization" association in order to attain a correct therapeutical procedure is stressed. The authors then report the results of a study conducted on patients affected by varices to establish the efficacy of a treatment by means of elastic stockings with graduated compressive pressure and the efficacy of reflex-rheography as a noninvasive, economical and easy-to-use method for the assessment of the variations in venous return flow produced by the association of muscular activity and elastocompression.     

Cadmium uptake and depuration in different organs ofLymnaea stagnalis L. and the effect of cadmium on the natural zinc level

The uptake of cadmium (0.1 mg/L) into various organs of the pond snailLymnaea stagnalis L., the depuration of accumulated Cd, and the change in the natural Zn level under the influence of Cd treatment were investigated during a 2 month period. The snails were fed with lettuce (Latuca sativa). The concentrations of Cd were measured in the whole soft body, various organs (liver, viscera, foot), the shell and the lettuce; and zinc concentrations were measured in various organs and the lettuce. As its Cd concentration remained at 10 g/g, which was much lower than the initial value for the soft body (69.4±5.71 g/g), the shell, according to our results, is incapable of accumulating Cd. The uptake pattern of the soft body showed a correlation with the initial Cd levels depending on differences in the Cd concentration of the lettuce. At the higher initial value (69.4±5.71 g/g) the linear Cd uptake began later then it did at the lower initial value; afterwards the snail was saturated with Cd. In the case of the lower, 9.02±1.3 g/g initial concentration, a rapid linear Cd uptake occurred till the 7th day, then the intensity of the uptake decreased. Saturation occurred at 200 g/g Cd concentration, regardless of the initial value. At the lower initial tissue level, the foot and the viscera showed a linear uptake pattern, while the liver, which has the greatest accumulation ability, displayed a logarithmic uptake pattern. The initial and the final Cd concentrations in the foot, viscera, and liver of theL. stagnalis were as follows: 10.3±2.15–60.1±7.13, 5.15±1.04–156±27.2, 14.1±3.09–430±23.3 g/g respectively. The bioconcentration factors (CF) were in the 10² (foot) and 10³ (viscera, liver, soft body) orders of magnitude. Forty to 45% of the accumulated Cd was depurated in Cd-free tap water; during the first three days of the uptake period, a negative linear correlation was found between Cd and Zn levels in the snail organs.