Assessment of echographic regression criteria in ruthenium-irradiated melanoma

Steady flattening of the tumor, increasing reflectivity and decreasing vascularity are echographic signs of successful irradiation treatment. The specific example of an irradiated choroidal melanoma shows that the absence of echographic changes by no means excludes tumor destruction. Because of a dense vitreous body hemorrhage, the melanoma could only be evaluated echographically. Since the echogram lacked evidence of regression, the tumor was locally resected 5 months later. Histology, however, revealed an amorphous mass of dead tissue pervaded by intact vessels. Apparently a successfully irradiated melanoma may generate an echo typical of vital melanoma tissue. The authors therefore draw the conclusion that only a steady tumor growth, as substantiated by an echogram, may be considered an unambiguous sign of tumor vitality.     

Comparison of the effectiveness and safety of levobunolol and timolol in ocular hypertension and chronic open-angle glaucoma

Twenty-six patients with open-angle glaucoma or ocular hypertension were studied in a concomitant double-masked clinical trial lasting three months, in which the ocular hypotensive efficacy and safety of levobunolol (0.5%) and timolol (0.5%), topically administered twice daily, were compared. At all follow-up examinations there was a significant decrease in mean intraocular pressure from baseline in both treatment groups, with no significant difference between them in this regard. Few changes were seen in either treatment group in cup/disk ratio, visual fields, visual acuity, biomicroscopy, or ophthalmoscopy. In both groups slight decreases in mean blood pressure were observed. Levobunolol and timolol were similarly effective and safe in reducing intraocular pressure in patients with chronic open-angle glaucoma and those with ocular hypertension.     

Nachstarbildung nach Intraokularlinsenimplantation

Zusammenfassung Der Nachstar ist die häufigste Komplikation nach Kataraktoperation. Seine Rate wurde durch die gründliche Entfernung der Rindenreste und die Einführung scharfkantiger Optiken drastisch gesenkt. Der Einfluss von Linsendesign und Optikmaterial im Detail wurde in Wien in prospektiv randomisierten intraindividuellen Vergleichstudien unter Einsatz objektiver Graduierungsmethoden systematisch untersucht. Die zirkuläre Überlappung der Optik erwies sich als Voraussetzung für die dauerhafte Wirksamkeit der scharfen Hinterkante. Durch kapselsackgerechte Haptiken mit schlanker Optikanbindung und Fibrose induzierende Optikmaterialen konnte der regeneratorische Nachstar weiter verringert werden, während sich die Politur des vorderen Kapselblatts als kontraproduktiv herausstellte. Eine wichtige Erkenntnis war, dass der Nachstar in seiner Häufigkeit und Ausprägung durch diese konventionellen Maßnahmen zwar drastisch gesenkt, jedoch nicht gänzlich vermieden werden kann.     

Intraocular pressure following small-incision cataract surgery and polyHEMA posterior chamber lens implantation. A comparison between acetylcholine and carbachol.

Ninety patients who had phacoemulsification and implantation of a flexible polyHEMA intraocular lens (IOGEL 1103) were assigned to three groups. After evacuation of sodium hyaluronate retrolentally from the capsular bag, 0.5 ml of 1% acetylcholine chloride, 0.01% carbachol, or balanced salt solution was instilled into the anterior chamber following wound closure. Intraocular pressure (IOP) was measured the day before, and six hours, 18 hours, and one week postoperatively. No topical or systemic antiglaucomatous drug was given during the study period. Preoperatively and one week postoperatively there was no significant difference between the three groups (P greater than .01). At six hours postoperatively the mean IOP decreased in the carbachol group (-2.8 mm Hg) and increased in the acetylcholine and control groups (+0.6 mm Hg and +/- 4.7 mm Hg) when compared with baseline pressures. At 18 hours the mean change from baseline was -3.0 mm Hg in the carbachol group, +0.8 mm Hg in the acetylcholine group, and +2.3 mm Hg in the control group. At six hours IOP exceeding 22 mm Hg was observed in ten of the control patients (30%) receiving balanced salt solution intracamerally and four of the acetylcholine patients (13.3%) but none of the carbachol patients. At 18 hours IOP remained above 22 mm Hg in three of the acetylcholine patients (10%) and four of the control patients (13.3%). Only one of the carbachol patients developed an increase of IOP up to 26 mm Hg at 18 hours. Removal of viscoelastic substances from behind the IOL reduced the incidence of pressure spikes in the early postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS)     

Severe adolescent head injury: Implications for transition into adult life

This report describes the outcomes of 28 children who had severe head injuries between 13–18 years of age. All were unconscious at least 24 hours and have been followed at least 2 years after injury. At present, their ages range from 18 to 27 years. Their educational achievements, social activities, marital status, functional independence, and employment at follow-up are described.     

Distribution of circulation-derived endothelial progenitors following systemic delivery.

Cells with an endothelial phenotype can be cultured from peripheral blood. These cells include cells of a monocytic origin with endothelial features (culture-modified mononuclear cells, CMMCs) and, at later time points, blood outgrowth endothelial cells (BOECs). Both are promising candidates for systemic cell-based cardiovascular therapies and each may have unique capabilities. Indeed, the combined use of both cell types has been shown to have synergistic therapeutic features requiring simultaneous delivery. However, the majority of preclinical studies of cell delivery have used splenectomized animals to increase systemic distribution. The goal of this study was to directly compare the distribution of these two cell types following systemic delivery in an intact animal model. A similar pattern of delivery was seen following delivery of both cell types with detection in the lung, liver, bone marrow, and spleen. Taken together, the data suggest that strategies using systemic delivery of circulation-derived cells must consider the distribution and efficiency of delivery in intact animals.