Relationship of duration and onset of diabetes to prevalence of diabetic retinopathy

In a population study of all registered insulin-treated diabetic patients on the Swedish island of Gotland, the prevalence of diabetic retinopathy was determined with ophthalmoscopy, biomicroscopy, and color photography. Retinopathy was present in 173 of 368 patients (47%) and reached a prevalence of 100% after 30 years of diabetes. Proliferative retinopathy was found in 48 subjects (13%) and was more common in females (17%) than in males (9.4%) (P = .01). By simple logistic regression test, the prevalence of total and proliferative retinopathy was correlated with both duration and age at onset of diabetes (P less than .001). However, on multiple regression analysis only the relationship with duration was statistically significant (P less than .001); age at onset was not (P greater than .2). Age had an additional influence only on background retinopathy with hard exudates, which were more frequent in older subjects (P less than .01). Thus, age at onset of diabetes was not correlated with the prevalence of total or proliferative retinopathy.     

Success and complications of pneumatic retinopexy

Fifty-eight consecutive patients with rhegmatogenous retinal detachment were treated by pneumatic retinopexy using intravitreal perfluoropropane gas. Reattachment was achieved in 29 of 35 eyes (83%) having single retinal breaks (up to 45 degrees in extent), including dialyses (up to 60 degrees), and groups of breaks within one clock hour. The cumulative reattachment rate was 37 of 58 eyes (64%), including eyes with detachments with multiple breaks 30 to 120 degrees apart and vitreous hemorrhage as well as aphakic and pseudophakic eyes. Pneumatic retinopexy was successful in 18 of 22 (82%) myopic eyes (-3 to -11 diopters). Virtually all complications developed in the inferior retinal quadrants, and included preretinal vitreous condensations or membranes in 27 of 58 eyes (47%), new retinal breaks in seven eyes (12%), and rhegmatogenous or tractional detachments in previously attached areas in 14 eyes (24%). Postoperative proliferative vitreoretinopathy occurred in six eyes (10%) and macular pucker in two (3%).     

Retinal detachment and pathology following experimental embolization of choroidal and retinal circulation

Summary By means of a micro-surgical technique, the central retinal artery of the owl monkey (Aotus trivirgatus) was embolized with spheric plastic beads (7–25 in diameter). Beads (4–15 ) were also injected into choroidal capillaries through a supero-temporal vortex vein.Choroidal ischemia induced proliferation or degeneration of the pigment epithelium, frequently accompanied by photoreceptor degeneration and circumscribed retinal detachment. Occlusion of retinal vessels resulted in posterior vitreous detachment and micro-cystoid degeneration in inner retinal layers, followed by retinal schisis. In combined retinal and choroidal ischemia long-lasting retinal detachments regularly developed.Supported by U.S. Public Health Service Fogarty International Fellowship IFO5 TWO1799-01 and the Swedish Medical Research Council (Project B72-60R-3655)     

Human superoxide dismutase 1 (hSOD1) maturation through interaction with human copper chaperone for SOD1 (hCCS)

Copper chaperone for superoxide dismutase 1 (SOD1), CCS, is the physiological partner for the complex mechanism of SOD1 maturation. We report an in vitro model for human CCS-dependent SOD1 maturation based on the study of the interactions of human SOD1 (hSOD1) with full-length WT human CCS (hCCS), as well as with hCCS mutants and various truncated constructs comprising one or two of the protein's three domains. The synergy between electrospray ionization mass spectrometry (ESI-MS) and NMR is fully exploited. This is an in vitro study of this process at the molecular level. Domain 1 of hCCS is necessary to load hSOD1 with Cu(I), requiring the heterodimeric complex formation with hSOD1 fostered by the interaction with domain 2. Domain 3 is responsible for the catalytic formation of the hSOD1 Cys-57-Cys-146 disulfide bond, which involves both hCCS Cys-244 and Cys-246 via disulfide transfer.     

Transmediastinal gunshot wounds in a mature trauma centre: Changing perspectives

Background

Transmediastinal gunshot wounds are associated with a high mortality and frequently require operative intervention. The purpose of this study was to identify the diagnostic and therapeutic challenges of these injuries in a mature trauma system with decreasing prehospital time intervals.

Methods

Patients admitted to a large urban Level 1 trauma centre between 1/2006 and 12/2010 sustaining a firearm injury to the torso were identified. Transmediastinal gunshot wounds were defined as missile tracts traversing the mediastinum identified on CT images, operative notes or autopsy reports.

Results

Overall, 133 patients met study criteria. A total of 116 patients (87.2%) were haemodynamically unstable or had no vital signs on arrival to the Emergency Department. Ninety-seven (83.6%) of these patients required a resuscitative thoracotomy resulting in 8 survivors (6.0%). There were 17 haemodynamically stable patients (12.8%) identified, 14 of whom underwent CT scan evaluation. Six patients subsequently required operative intervention. Only 11 patients (8.3%) in the study population were successfully managed nonoperatively. The overall mortality was 78.9%, and for those who reached the hospital with vital signs, the mortality was 24.3%.

Conclusions

Transmediastinal gunshot wounds encountered in a mature trauma centre are highly lethal injuries requiring resuscitative thoracotomy in most instances. Changing perspectives in these injuries may reflect the effects of an evolving prehospital care.     

Cubic Iron Core–Shell Nanoparticles Functionalized to Obtain High-Performance MRI Contrast Agents

Nanoparticles with SiO 2 coating were synthesized to have a cubic iron core. These were found to have saturation magnetization very close to the highest possible value of any iron-containing nanoparticles and the bulk iron saturation magnetization. The in vitro toxicology studies show that they are highly biocompatible and possess better MRI contrast agent potential than iron oxide NPs.     

Validity of utilities of patients with esophageal cancer

OBJECTIVES: The convergent validity between utility assessment methods was assessed. METHODS: Investigated were patients with esophageal cancer treated surgically with curative intent. Patients were interviewed in a period from 3 to 12 months after surgical resection. Patients evaluated their actual health and seven other states. Visual analogue scale (VAS) and standard gamble (SG) utilities were obtained for the health states in an interview. Patients also indicated whether or not they preferred death to living in a health state (worse than dead [WTD] preferences). RESULTS: Fifty patients completed the interview. Convergent validity was excellent at the aggregate and individual level. However, the relation between VAS and SG differed strongly across individuals. On a scale from 0 (dead) to 100 (perfect health), SG scores were lower for patients with WTD preferences (mean difference d = 35; p = .002); however, VAS scores did not vary by WTD preferences. CONCLUSIONS: In general, there is good agreement between VAS and SG measures, although patients disagree about how the VAS and SG are related. The standard gamble varied by WTD preferences, however, the VAS did not.