bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of 99mTc-DTPA Aerosols for Lung Permeability Studies
Authors: Diot Patrice , Galinier Elisabeth , Grimbert Daniel , Bugeon Sylvie , Valat Chantal , Lemarié Etienne , Diot Elisabeth , Baulieu Jean-Louis , Besnard Jean Claude , Guilloteau Denis
Published: April 2003

Background: The interpretation of 99mTc diethylenetriamine pentaacetate (99mTc DTPA) aerosol clearance is based on the hypothesis that the 99mTc-DTPA complex is not altered by the nebulization process. Objectives: To characterize (1) the radiochemical purity (RCP) of 99mTc-DTPA and the stability of labeling after jet nebulization, and (2) the particle size distribution of the aerosol. Methods: RCP and stability – the aerosol was driven by oxygen, captured on filters which were eluted and RCP was checked by thin layer chromatography. Particle size distribution – the aerosol was generated using dry air (50 psi) at three different flow rates, i.e. 3 (1 run), 6 (4 runs) and 9 l·min–1 (4 runs). The mass median aerodynamic diameter (MMAD) and the geometric standard deviation (σg) were determined using a cascade impactor from the radioactivity counted on each stage. Results: The RCP was more than 95% in all cases. Mean MMAD (±SD) was 0.70 µm (±0.07) at 9 l·min–1, 0.93 µm (±0.05) at 6 l·min–1 (p < 0.05) and 1.50 µm at 3 l·min–1. Mean σg (±SD) was 2.02 (±0.08) at 9 l·min–1, 2.00 (±0.16) at 6 l·min–1 and 1.90 at 3 l·min–1. Conclusion: This study demonstrates (1) that the high RCP of 99mTc-DTPA is not affected by jet nebulization, even when using oxygen at a high flow rate, and (2) that when using a flow rate between 6 and 9 l·min–1, the MMAD remains optimal for peripheral lung deposition.
Drug-Induced Bronchospasm: Analysis of 187 Spontaneously Reported Cases
Authors: Leuppi Jörg D. , Schnyder Pia , Hartmann Katharina , Reinhart Walter H. , Kuhn Max
Published: April 2003

Background: The Swiss Drug Monitoring Center (SANZ) uses a systematic approach to the collection of spontaneously reported individual cases on suspected adverse drug reactions (ADRs). Spontaneous reporting schemes are designed to detect new, rare and unexpected ADRs and to act as an early warning system but there is a tendency to overreport severe reactions. Objectives: The aim of the study was to determine drug-induced episodes of bronchospasm, their seriousness and predisposing risk factors. An ADR is classified as serious if the reaction results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability or incapacity. Results: From 1986 to 1995 SANZ received 8,191 case reports of suspected ADRs. In 187 cases (2%) bronchospasm was reported. In 55% of these cases the reaction was regarded as serious. Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) were reported most frequently and were involved in 24% of the cases of which 64.5% were classified as serious. In three cases a lethal outcome was reported after intravenous administration of metamizol. Anti-infectious agents were implicated in 18% (52% serious), cardiovascular drugs in 11% (50% serious), drug formulation agents in 9% (41% serious), vaccines and immunoglobulins in 5.5% (50% serious), and plasma volume expanders in 5.5% (80% serious). Other drug groups were involved in 27% of the cases. About 50% of patients experiencing bronchospasm after NSAIDs, pharmaceutical formulation agents, vaccines and immunoglobulins had predisposing risk factors such as asthma, atopy or drug allergy. In other drug groups a predisposing factor was identified in 27% or less. Conclusion: Drug-induced bronchospasm is frequently reported with NSAIDs, anti-infective agents, cardiovascular drugs and excipients with a high proportion of serious reactions.
Quantification of the Size of Primary Spontaneous Pneumothorax: Accuracy of the Light Index
Authors: Noppen Marc , Alexander Patrick , Driesen Peter , Slabbynck Hans , Verstraete André
Published: April 2003

Background: The size of a pneumothorax (PTX) is usually estimated by the Light index. Treatment strategies of (primary, spontaneous) PTX partially depend upon the size of the PTX. To our knowledge, the Light index has not yet been correlated with the actual volume of the PTX. Objectives: To correlate the estimated size of a primary spontaneous PTX by means of the Light index, with the actual amount of air present in the pleural space. Methods: Actual PTX volumes were measured by means of manual aspiration of air present in the pleural space in 18 patients with primary spontaneous PTX and correlated with the size estimation obtained by the Light index. Results: Light index and volume measurements were strongly correlated (r = 0.84, p < 0.0001). Conclusions: The Light index is a good estimate of the actual size of a (primary spontaneous) PTX.
Aortobronchial Fistula Presenting as Recurrent Hemoptysis and Successfully Treated with an Endovascular Stent Graft
Authors: Yoo Ji-Hoon , Lee Choon-Taek , Shim Young-Soo , Chung Jin Wook , Ahn Hyuk , Kim Kyung Whan
Published: April 2003

Aortobronchial fistula (ABF) (aortopulmonary fistula) may cause a massive fatal hemoptysis. We have recently seen a patient with ABF presenting with recurrent, massive hemoptysis. She was successfully treated with an endovascular stent graft. The endovascular stent graft may provide an alternative treatment of in patients considered to be poor surgical candidates.
Pulmonary Tuberculosis in Patients with Diabetes mellitus
Authors: Bacakoğlu Feza , Başoğlu Özen Kaçmaz , Çok Gürsel , Sayıner Abdullah , Ateş Mahmut
Published: April 2003

Background: Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis, but there are varying data, particularly regarding the association with lower lung field involvement. Objectives: To determine whether diabetes mellitus alters the clinical and radiographic manifestations of tuberculosis in nonimmunocompromised hosts and to define the determinants of lower lung field involvement. Methods: A retrospective review of the records of all patients with tuberculosis and diabetes mellitus seen during a 14-year period and of an age- and sex-matched nondiabetic control group with tuberculosis was carried out. The duration of symptoms, tuberculin reaction, bacteriologic and radiographic findings of the two groups were compared. Results: The presence of diabetes mellitus was found not to have an effect on patients’ symptomatology, bacteriology results, tuberculin reaction and localization of pulmonary infiltrates. On the other hand, fewer diabetic patients were smear-positive and fewer had reticulonodular opacities compared with the control patients. A higher number of insulin-dependent diabetic patients presented with cavitary disease as compared with nondiabetic controls. Lower lung field tuberculosis was significantly associated with female gender and, in patients older than 40 years, was more frequently observed in diabetics. Conclusion: These data show that diabetes does not affect the presenting features of pulmonary tuberculosis to a large extent and is only associated with lower lung field disease in older patients.
Clinical Course and Management of Patients Undergoing Open Window Thoracostomy for Thoracic Empyema
Authors: Maruyama Riichiroh , Ondo Kaoru , Mikami Koji , Ueda Hitoshi , Motohiro Akira
Published: April 2003

Background: While open window thoracostomy (OWT) is a safe procedure and is indicated in patients who have thoracic empyema either with or without a bronchopleural fistula, it may prolong the hospital stay. Objectives: We retrospectively analyzed the relationship between the etiology of thoracic empyema and the open window interval (OWI). Methods: Between January 1986 and May 1997, 53 patients resistant to conventional therapy underwent OWT for thoracic empyema at the Department of Surgery of the National Minami-Fukuoka Chest Hospital. The patients were classified into five groups based on the etiological findings of thoracic empyema. 44 patients also underwent closure of the window until June 1999. Results: The average OWI was 180.4 ± 51.9 (mean ± SE) days for postoperative empyemas in lung cancer, 128.0 ± 32.1 days for bacterial nontuberculous empyemas, 189.6 ± 24.1 days for fungal empyemas, 365.8 ± 201 days for empyemas caused by atypical mycobacteria and 322.0 ± 58.7 days for tuberculous empyemas. There was no evidence that the OWI was related to either sex, age, etiology of thoracic empyemas, performance status, the existence of bronchopleural fistulae, complications of diabetes mellitus or preoperative malnutrition status in multivariable models. 5 patients underwent a second OWT because of recurrence of empyema. Mortality rate was 7.5%. Conclusions: There was no relationship between clinical factors including nutritional assessment and OWI. OWT generally is a safe and effective procedure for thoracic empyema resisting to conventional therapy except that it can make an extended hospital stay necessary.
Bronchiolitis obliterans Organizing Pneumonia Associated with Evans Syndrome
Authors: Máiz Luis , Muñoz Arturo , Maldonado Soledad , Pacheco Adalberto , Lamas Adelaida , Fogué Luis
Published: April 2003

The association of bronchiolitis obliterans organizing pneumonia (BOOP) with insulin-dependent diabetes mellitus (IDDM) and Evans syndrome (autoimmune pancytopenia) has not been reported previously. We describe the case of a 4-year-old child diagnosed with IDDM and Evans syndrome who presented malaise, fever and nonproductive cough for several months. The chest radiograph revealed several patchy alveolar opacities with peripheral and bilateral distribution and multiple hilar and mediastinal adenopathies. An open lung biopsy established the diagnosis of BOOP. During the follow-up over the next 7 years, the patient had chronic relapses in spite of corticosteroid treatment and developed restrictive lung disease.
Helicobacter pylori: A Debated Factor in Gastroesophageal Reflux Disease
Authors: Sharma Prateek
Published: April 2003

The prevalence of Helicobacter pylori infection is steadily decreasing in developing countries, and this has been paralleled by an increasing incidence of gastroesophageal reflux disease (GERD) and adenocarcinomas of the esophagus and of the esophagogastric junction. The prevalence of H. pylori infection, which is on the decline in Europe and in the United States, is probably related to improvements in sanitary conditions and socioeconomic status. These epidemiological data do not support a role for H. pylori in the pathogenesis of GERD, but at the same time suggest a negative association with the rising incidence in esophageal diseases. While H. pylori infection clearly does not cause GERD, it may protect certain susceptible individuals from the development of GERD and its complications. There are conflicting reports that GERD can develop after H. pylori eradication and that proton pump inhibitors are less effective in suppressing intragastric acidity in H. pylori negative patients – reasons not to eradicate H. pylori in GERD patients. On the contrary, other data suggest an increase in the development of atrophic gastritis in GERD patients (H. pylori positive) on long-term proton pump inhibitor therapy – a reason to eradicate H. pylori. Preexisting lower esophageal sphincter dysfunction, susceptibility to GERD, unmasking of latent GERD, and patterns and severity of gastritis may be important factors contributing to the development of GERD rather than just the presence or absence of infection with H. pylori.
Multifocal Choroiditis: Indocyanine Green Angiographic Features
Authors: Vadalà Maria , Lodato Gaetano , Cillino Salvatore
Published: April 2003

The aim of this study is to retrospectively evaluate the indocyanine green (ICG) angiographic features in 13 patients affected by multifocal choroiditis. We identified two clinical and angiographic patterns. The ‘active’ pattern showed hypofluorescence up to the late phases and more extensive choroidal involvement than presumed by ophthalmoscopy and fluorescein angiography. In the ‘inactive’ pattern, ICG angiography showed hypofluorescence during all the phases: no increase in lesion number was observed between early and late phases. Choroidal neovascularization was present in 10 patients, and it was bilateral in 2 of these: it occurred only in the inactive stage. The appearance of choroidal lesions in IGC angiography supports the hypothesis of inflammatory involvement of the choriocapillaris as the pathophysiological mechanism of the disease.
Les uvéites: aspects épidémiologiques à l’hôpital Laquintinie de Douala
Authors: Bella-Hiag Assumpta , Mvogo Côme Ebana , Ellong Augustin
Published: April 2003

Objectif: Afin de dégager les caractéristiques épidémiologiques des uvéites dans notre contexte camerounais, nous avons réalisé une étude rétrospective en milieu hospitalier. Patients et méthode: 38 patients sur 5420 ont consulté pour une uvéite sur une période de 6 ans (0,7%). Cette population comportait 13 femmes et 25 hommes. Leurs âges variaient de 10 ans à 57 ans, pour une moyenne de 33,9 ans. Résultats: 81,6% des uvéites étaient unilatérales et la forme clinique antérieure était la plus fréquente avec 51,1% des cas. Une étiologie a été identifiée ou suspectée chez 24 patients (63,1%), au premier rang desquelles la sinusite (45,8%), suivie par la toxoplasmose (29,2%). L’étude de la fonction visuelle a révélé que le traitement médical était généralement efficace (72,2% d’améliorations), bien que 2 patients (3 yeux) aient perdu la vue. Discussion et conclusion: Malgré sa rareté, cette pathologie nous interpelle donc du fait des difficultés du diagnostic étiologique, mais aussi de son évolution inéluctable, dans certains cas, vers la cécité.
The Relationship between Intraocular Pressure and Glaucoma in a Defined Population
Authors: Bonomi Luciano , Marchini Giorgio , Marraffa Michele , Morbio Roberta
Published: April 2003

Purpose: To provide data on the prevalence of ocular hypertension and glaucoma and on the diagnostic validity of tonometry. Methods: In this cross-sectional, population-based study, 4,927 subjects over 40 years of age were examined. Each subject underwent a complete ocular examination as part of the Egna-Neumarkt Glaucoma Study. These examinations were carried out by trained, quality-controlled ophthalmologists, according to a predetermined standard protocol that included a medical interview, applanation tonometry, computerized perimetry, optic nerve head examination and other ocular measurements. The following data were recorded: mean IOP, prevalence of ocular hypertension, primary open-angle glaucoma and normal tension glaucoma. Sensitivity, specificity and the predictive value of the tonometric test, as well as the distribution of IOP in the different groups were also determined. Results:  The overall prevalence of ocular hypertension, hypertensive primary open-angle glaucoma and normal tension glaucoma corresponded to 2.1, 1.4 and 0.6%, respectively. Other types of glaucoma accounted for a further 0.9%. The sensitivity and specificity of the tonometric test in recognizing glaucoma (cut-off between 21 and 22 mm Hg) were, respectively, 80.1 and 97.8%. The predictive values of the positivity and negativity of the test were 52.1 and 99.4%, respectively. Conclusions: The prevalence of ocular hypertension and glaucoma was similar to that found in several recent epidemiological studies. Tonometry alone is obviously not sufficient to ascertain or to exclude the presence of glaucoma; its diagnostic validity however is high and should never be underestimated. An elevated IOP is the main risk factor for glaucoma, with the degree of risk increasing as the level of IOP increases.
Prevalence of Colour Blindness in Young Jordanians
Authors: Al-Aqtum Musa T. , Al-Qawasmeh Mohammed H.
Published: April 2003

Colour blindness is one of the common genetic disorders observed in all human populations. It is a sex-linked recessive trait. The genes are located on the X chromosome within the Xq28 band. 1,418 university students (1,200 female and 218 male) from Zarka Private University and the Hashemite University were randomly selected and tested for congenital red/green colour blindness, by using Ishihara pseudo-isochromatic colour plates. A total of 23 individuals were found to be colour blind. In females, 4 students (0.33%) were colour blind: 1 of them showed protanomalia, 1 protanopia and 2 deuteranomalia. In males, 19 students (8.72%) were colour blind: 4 showed protanomalia, 3 protanopia, 8 deuteranomalia and 4 deuteranopia. The allelic frequencies of the colour vision gene were found to be 0.087 in males, 0.003 in females and 0.016 in the total population. Studies on colour blindness in Jordan are very few; this population-based investigation is meant to fill a gap in this field.
Topical 0.1% Indomethacin Solution versus Topical 0.1% Dexamethasone Solution in the Prevention of Inflammation after Cataract Surgery
Authors: Missotten Luc , Richard Christine , Trinquand Claude
Published: April 2003

Purpose: To compare the efficacy and safety of topical 0.1% indomethacin with 0.1% dexamethasone after cataract surgery. Methods: 145 patients (indo = 71, dexa = 74) were enrolled in a randomised, double-masked study and received one drop 4 times a day of indomethacin or dexamethasone for 1 month. Results: Proteinic flare and cellular Tyndall decreased with time in both groups, with a difference in favour of indomethacin for cellular Tyndall on day 30 (p = 0.046). Conjunctival hyperaemia was less pronounced in the dexamethasone group on day 30 (p = 0.03). Tolerance of both drugs was good. Conclusion: 0.1% Indomethacin solution appears to be as safe and efficient as 0.1% dexamethasone eyedrops in the management of post-operative inflammation and could be a good alternative to the use of steroids.
Breast Carcinoma Metastatic to the Eyelid Presenting as the First Sign of Insufficient Chemotherapy
Authors: Colombo Fernando , Cursiefen Claus , Holbach Leonard M.
Published: April 2003

Metastatic eyelid tumors are uncommon. Their presentation may vary markedly. We describe a 61-year-old female who presented with a tender nodule in her right upper eyelid shortly after chemotherapy for metastatic disease. She had undergone right mastectomy and radiotherapy because of an adenocarcinoma 16 years ago. Histopathologic findings were consistent with metastatic carcinoma. Knowledge of the diverse clinical and histopathologic features of metastatic breast carcinoma to the eyelids is essential for the appropriate management of these patients. Breast carcinoma metastatic to the eyelid represented in this patient the only sign of insufficient chemotherapy.
Value of Positron Emission Tomography in the Diagnosis of Malignant Ocular Tumors
Authors: Spraul Christoph W. , Lang Gabriele E. , Lang Gerhard K.
Published: April 2003

Purpose: To address the question whether positron emission tomography (PET) can identify malignant ocular tumors. Methods: In patients with ocular tumors, PET was performed using the incorporation of the glucose analogue 18F-2-fluoro-2-deoxy-D-glucose. The diagnosis of the ocular lesions was based on conventional diagnostic procedures including histologic examination. Results: Nineteen patients with a mean age of 62.8 ± 14.2 years were included in this study. Nine patients with a mean age of 62.9 ± 13.1 years displayed the presence of a malignant tumor including metastatic lesions (4), malignant melanomas (4) and squamous cell carcinoma (1). Additionally, 10 patients with a mean age of 62.8 ± 15.9 years with benign lesions were studied. There was a statistically significant difference (p = 0.012) in tumor height and tumor volume, but not in tumor diameter between benign and malignant lesions. The smallest PET positive lesion measured 7 × 3 mm. PET was positive in 7 out of 9 malignant lesions and negative in all 10 benign lesions, i.e. there was no false-positive and two false-negative results. The two false-negative tumors represented malignant melanomas of the choroid. Additionally, results of the PET examination were independent of tumor size. Conclusion: PET seems to be of limited value for the diagnosis of malignant melanoma of the choroid, i.e. a negative result does not exclude a malignant process.
Comparisons of Intraocular-Pressure- Lowering Efficacy and Side Effects of 2% Dorzolamide and 1% Brinzolamide
Authors: Seong Gong Je , Lee Sung Chul , Lee Jong Hyuck , Chu Young Kwang , Hong Young Jae
Published: April 2003

Forty-one healthy volunteers were recruited for a study to compare the intraocular pressure (IOP)-lowering efficacy and side effects of 2% dorzolamide and 1% brinzolamide. In a randomized double-blind design, one eye received one drop of 2% dorzolamide and the other eye received one drop of 1% brinzolamide. The IOP and side effects were evaluated by Goldmann applanation tonometry and slit lamp biomicroscopy before administration, and 3, 7 and 14 days after the initial administration of eyedrops. The IOP decreased significantly from baseline for both drugs (p < 0.05). However, there were no statistically significant differences between 2% dorzolamide and 1% brinzolamide either before or after eyedrop administration (p > 0.05). The most frequent side effect was ocular pain in the case of 2% dorzolamide and blurred vision in 1% brinzolamide. The results suggested that 2% dorzolamide and 1% brinzolamide have similar IOP-lowering efficacies with different side effects
Effects of Topical Vitamin E on Keratocyte Apoptosis after Traditional Photorefractive Keratectomy
Authors: Bilgihan Kamil , Adiguzel Ufuk , Sezer Cem , Akyol Gulen , Hasanreisoglu Berati
Published: April 2003

Purpose: To evaluate the keratocyte apoptosis and effects of topical vitamin E on keratocyte apoptosis after photorefractive surgery. Methods: Rabbits were divided into 7 groups, and all groups were compared with controls after epithelial scraping, epithelial scrape and photorefractive keratectomy (PRK) (traditional PRK), transepithelial PRK, production of a corneal flap with microkeratome and laser-assisted in situ keratomileusis (LASIK). The effects of topical Vitamin E treatment were investigated in the traditional PRK group. The terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling assay (to detect DNA fragmentation in situ) and light microscopy have been used to detect apoptosis in rabbit cornea. Results: Transepithelial PRK induced minimal keratocyte apoptosis, less than in all other refractive surgical procedures. The greatest amount of keratocyte apoptosis was observed after traditional PRK (p = 0.001), therefore we tested the effects of topical vitamin E in this group. The number of apoptotic keratocytes significantly reduced after vitamin E therapy (p < 0.005). Conclusion: Keratocytes undergo apoptosis after refractive surgery in response to mechanical epithelial removal, preparing of corneal flap and excimer laser stromal photoablation. The topical application of vitamin E immediately after surgery can prevent keratocyte apoptosis, and this result suggests that free radicals may be partly responsible for keratocyte apoptosis after excimer laser keratectomy.
Effects of Contact Lenses on Corneal Endothelium – A Morphological and Functional Study
Authors: Chang Shu-Wen , Hu Fung-Rong , Lin Luke Long-Kuang
Published: April 2003

Purpose: To study the corneal endothelial morphological changes and endothelial barrier function in contact lens wearers. Methods: Specular microscopy and anterior segment fluorophotometry were performed on 116 controls (group 1) and 76 daily wear soft contact lens wearers. Group 2 patients (n = 34) had been wearing contact lenses for less than 5 years and group 3 (n = 42) for more than 5 years. The relationship of corneal thickness, endothelial cell density, hexagonal cell percentage, coefficient of variation in cell area, corneal autofluorescence and corneal endothelial permeability to the contact lens wear duration was studied. Results: The average corneal thickness of contact lens wearers did not differ significantly from controls (0.533 ± 0.031, 0.538 ± 0.044, 0.532 ± 0.031 mm for groups 1, 2 and 3, respectively; p = 0.89). However, there was a significant tendency toward corneal thinning with a longer history of contact lens wear (r = –0.31, p = 0.002 in groups 2 and 3). The percentage of hexagonal cells decreased with both increasing hours of contact lens wear per day (r = –0.36, p < 0.001) and the duration of contact lens wear in years (r = –0.33, p < 0.001), but there was no significant change in endothelial cell density in contact lens wearers. The coefficient of variation in cell size correlated more closely with increased hours of contact lens wear per day (r = 0.35, p = 0.002) than with the duration of contact lens wear in years (r = 0.12; p = 0.31). In the functional study, corneal autofluorescence increased in contact lens wearers (5.13 ± 0.71 ng/ml in group 1, 6.45 ± 2.03 ng/ml in group 2 and 7.21 ± 1.51 ng/ml in group 3, respectively, p < 0.001) and the mean endothelial permeability decreased in contact lens wearers (3.89 ± 0.95 ×10–4/cm in group 1, 2.71 ± 0.73 × 10–4/cm in group 2 and 2.95 ± 0.91 × 10–4/cm in group 3, respectively, p = 0.003). Conclusions: Daily wear soft contact lenses caused morphological changes in the corneal endothelium. With an increasing span of contact lens wear, there was a significantly increased variation in cell size, a decreased hexagonal cell percentage, an evident intercellular dark area and rosette formation. The corneal autofluorescence increased and the overall endothelial permeability decreased as a consequence of contact lens wear. Contact lens wear also caused corneal thinning, and the cornea became thinner with increasing duration of contact lens wear.
No Excess of Factor V:Q506 Genotype but High Prevalence of Anticardiolipin Antibodies without Antiendothelial Cell Antibodies in Retinal Vein Occlusion in Young Patients
Authors: Scott J.A. , Arnold J.J. , Currie J.M. , Broadfoot C. , Davidson M. , Kelly K.F. , Graham A. , Kirkpatrick J.N.P. , Greaves M.
Published: April 2003

Factor V:Q506 (factor V Leiden) is associated with venous thrombosis and has been reported to be a risk factor for retinal vein occlusion (RVO). Anticardiolipin antibodies (ACA), also associated with RVO, are a marker for the prothrombotic condition antiphospholipid syndrome, in which antiendothelial antibodies (AECA) are also frequently present. This study reviewed 45 younger patients ≤55 years old (21 with branch, 22 with central and 2 with hemispheric RVO) to examine: (1) the rôle of factor V:Q506 in the pathogenesis of RVO, and (2) the prevalence and titre of ACA and AECA in this group. No patient had the factor V:Q506 mutation indicating no increase in frequency above background. Our data suggest that primary screening for factor V:Q506 is not indicated for young patients with RVO who do not have historical evidence suggesting familial thrombophilia. Twenty-nine patients had low-titre ACA (>10 GPL units); in 6 of these, the titre was >20 GPL units (population reference range = 0–10 GPL units). No patient had antiendothelial cell reactivity. The low-titre ACA may therefore represent a non-specific response to vascular injury.
Transpupillary Thermotherapy for Choroidal Metastases
Authors: Ardjomand Navid , Kucharczyk Micha , Langmann Gerald
Published: April 2003

Introduction: We report on a case with bilateral choroidal metastases derived from a renal cell carcinoma 13 years after nephrectomy. The treatment modality is discussed. Methods: A male patient (58 years of age) presented with asymptomatic bilateral choroidal metastases deriving from renal cell carcinoma. The right kidney had been removed because of renal cell carcinoma 13 years before the appearance of the choroidal metastases. He had full visual acuity (20/20) and normal intraocular pressure in both eyes. Fundus examination showed a small tumor in the peripheral choroidea of his right eye and an intermediate-sized solid tumor in the periphery of his left eye. Results: The tumor of the right eye was treated by TTT and the tumor of the left eye by 106Ru plaque radiotherapy. The tumors showed total regression into flat chorioretinal atrophies in both eyes and no tumor could be found 13 moths after treatment maintaining full visual acuity (20/20). Conclusion: Asymptomatic ocular metastases can develop even many years after removal of the primary tumor. TTT and 106Ru brachytherapy are useful treatment modalities in cases of small and intermediate-sized choroidal metastases.
Thalidomide and Prednisolone Inhibit Growth Factor-Induced Human Retinal Pigment Epithelium Cell Proliferation in vitro
Authors: Kaven Corinna , Spraul Christoph W. , Zavazava Nicholas , Lang Gerhard K. , Lang Gabriele E.
Published: April 2003

Thalidomide and prednisolone were recently introduced as treatment modalities in age-related macular degeneration (AMD). Growth factor-induced activation of retinal pigment epithelial (RPE) cells is a crucial event in this disease. The purpose was to examine the effect of thalidomide and prednisolone on growth factor-preactivated RPE cells. Human RPE cells were stimulated with 10 ng/ml platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF), or vascular endothelial growth factor (VEGF) for 24 h. Afterwards, thalidomide (50 µg/ml) or prednisolone (100 ng/ml) were added for 24 h. RPE cell proliferation was determined by [3H]-thymidine incorporation. PDGF and bFGF significantly stimulated human RPE cell proliferation (p < 0.005), the value for VEGF stimulation was not significant (p = 0.3). The effect of the growth factors was diminished after addition of thalidomide and prednisolone (p < 0.005). The current study shows that the inhibitory properties of thalidomide and prednisolone remain even after growth factor activation of the cells.
Effect of Bradykinin on Cultured Bovine Corneal Endothelial Cells
Authors: Yang Suk-Woo , Lee Woon Kyu , Lee Eun-Jung , Kim Kyoung-Ah , Lim Young , Lee Kweon-Haeng , Rha Hyoung Kyun , Hahn Tae-Won
Published: April 2003

Purpose: To clarify the effect of bradykinin on cytosolic free calcium mobilization and cell proliferation in cultured bovine corneal endothelial cells (BCEC). Methods: The cytosolic free calcium concentration (Ca2+]i) was measured with the InCaTM Imaging System after the treatment of bradykinin (10–11 to 10–7 M) alone or with the pretreatments of EGTA, bradykinin receptor (Bk1 and Bk2) antagonists and an inhibition of phospholipase C (U-73122). Also, the effect of bradykinin on cell proliferation in BCEC was evaluated using cell counts. Results: In BCEC, [Ca2+]i in the resting state was 87 ± 9 nM. Bradykinin induced an increment of [Ca2+]i in a concentration-dependent manner and its 50% effective concentration was approximately 5 × 10–11 M. A [Ca2+]i increment at 10–8 M bradykinin was inhibited with the pretreatment of EGTA, an extracellular calcium chelator. U-73122 (5 × 10–6 M) attenuated the bradykinin-induced [Ca2+]i increment. The pretreatment of HOE-140 (Bk2 antagonist) almost attenuated the bradykinin (10–8 M)-induced [Ca2+]i increase, but des-Arg9-[Leu8]-bradykinin (Bk1 antagonist) did not suppress it. To investigate the physiological effect of bradykinin, the effect of bradykinin on cell proliferation was studied. 10–8 M of bradykinin produced a significant increase in cell numbers. This mitogenic effect of bradykinin was inhibited by the Bk2 antagonist. Conclusions: Bradykinin-induced stimulation of the signal transduction pathway in BCEC is coupled with the Bk2 type receptor. Furthermore, bradykinin produces the mitogenic effect in BCEC.
Use of Topical Clotrimazole in Human Keratomycosis
Authors: Mselle James
Published: April 2003

Twelve out of 15 patients (9 males and 6 females) with laboratory-proven fungal keratitis were treated with topical clotrimazole, a synthetic imidazole derivative. Their ages ranged from 8 to 70 years. The posttreatment visual acuities were significantly better than the pretreatment visual acuities. No significant biomicroscopic signs of ocular surface toxicity were noted. The ocular condition in 3 patients (all infected with Fusarium solani) deteriorated to blindness despite the antifungal therapy. Conclusion: The clotrimazole usually marketed as dermatological preparation can be used in a diluted form to treat human keratomycosis safely and successfully. A combination with a polyene derivative should be considered in the treatment of fungal corneal infection due to Fusarium spp.
The One-Month Effects of Topical Betaxolol, Dorzolamide and Apraclonidine on Ocular Blood Flow Velocities in Patients with Newly Diagnosed Primary Open-Angle Glaucoma
Authors: Avunduk Avni Murat , Sari Ahmet , Akyol Nurettin , Öztürk Orhan , Kapicioglu Zerrin , Erdöl Hidayet , Imamoglu Halil Ibrahim
Published: April 2003

Purpose: This double-masked, prospective and randomized clinical trial was planned to investigate with color Doppler imaging the 1-month vascular effects of betaxolol, dorzolamide and apraclonidine treatment on patients with newly diagnosed primary open-angle glaucoma (POAG). Methods: 22 consecutive patients with newly diagnosed POAG between the ages of 46 and 72 years were enrolled in this study. All patients were newly diagnosed cases and had not received any antiglaucoma medication before. Patients who had a systemic vascular disease (including systemic hypertension) or were taking β-blockers, nitrates or calcium channel blockers were excluded from the study. The patients were randomly divided into three groups. Groups A and B contained 7 patients, group C contained 8 patients. Group A patients were treated with topical betaxolol, group B patients received topical dorzolamide eye drops, and group C patients were treated with topical apraclonidine eye drops. Peak systolic velocities (PSV), end-diastolic velocities (EDV) and resistive indices (RI) in the right ophthalmic arteries (OA), central retinal arteries (CRA) and posterior ciliary arteries (PCA) were measured at baseline by using color Doppler imaging on a masked basis. On days 15 and 30 of treatment, the same measurements were repeated. The inter- and intragroup results were compared statistically. Results: Compared to pretreatment measurements, topical betaxolol therapy significantly decreased PSV only in the PCA and only on day 30 of treatment (p = 0.011). On days 15 and 30, dorzolamide decreased RI measurements in the PCA compared to pretreatment measurement (p = 0.013 and p = 0.011, respectively). Apraclonidine also decreased PSV in the OA on days 15 and 30 of treatment when compared to pretreatment values (p = 0.013 and p = 0.012, respectively). When 15-day measurements were compared between the groups, PSV in the OA were significantly higher in dorzolamide-treated patients compared to other groups (p = 0.01 and p = 0.011). On day 30 of treatment, PSV in the OA was also higher in the dorzolamide-treated group than the other groups (p = 0.012 and p = 0.01). Additionally, apraclonidine-treated patients had a significantly lower EDV in the OA than the other groups (p = 0.013 and p = 0.01). The RI in the OA was also significantly lower in the apraclonidine-treated group compared to the other groups (p = 0.01 and p = 0.011). Conclusion: Our study suggests that dorzolamide has the most advantageous 1-month effects on blood flow velocity in the retrobulbar arterial circulation of POAG patients. Betaxolol seems superior to apraclonidine in this regard. Our data may help the clinician when treating patients with POAG medically. Further studies using a larger population size may clarify our results.
Comparative Study of Pterygium Surgery
Authors: Iveković Renata , Mandić Zdravko , Sarić Dean , Sonicki Zdenko
Published: April 2003

The aim of this study was the comparison of recurrence rates of pterygia following different surgical methods. Twenty-one patients were operated by the bare sclera technique, with the application of mitomycin C (0.25 mg/ml for 2 min). Twenty-seven patients were operated by limbal stem cell transplantation. The third group contained 13 patients who were operated by amniotic membrane transplantation. Five recurrences of pterygia were noted in the mitomycin C group and 2 each in the limbal stem cell transplantation group and the amniotic membrane group. The mean time to recurrence was 5.4 ± 4.12 months in the mitomycin C group versus 10.5 ± 3.5 months in the group of patients with limbal transplantation. In the third group, both recurrences were evident 4 months after the operation.
Effect of Sulfur Hexafluoride Gas on Antibacterial Activity of Antibiotics in vitro against Agents Causing Endophthalmitis
Authors: Yanyali Ates , Cetin Sila , Talu Haluk , Vahaboglu Haluk
Published: April 2003

Background: We conducted a study to evaluate the effect of sulfur hexafluoride gas (SF6) on the antibacterial activity of antibiotics in vitro against Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa, which are common endophthalmitis-causing agents. Methods: In this experimental study, antibiotic susceptibility tests were prepared according to the National Committee for Clinical Laboratory Standards macrobroth dilution method. Müller-Hinton broth was the test medium. Standard P. aeruginosa (ATCC 27853), S. epidermidis (ATCC 12228) and S. aureus (ATCC 29213) strains were studied. For P. aeruginosa ceftazidime, ofloxacin and tobramycin dilutions, and for S. epidermidis and S. aureus, cefazolin, ofloxacin and tobramycin dilutions were prepared identically in two sets of tubes. One set of tubes, into which pure SF6 was injected, was defined as the SF6 group. The other set of tubes, into which no SF6 was injected, was taken as the control group. To determine the minimal bactericidal concentrations of the antibiotics, subcultures were made onto Müller-Hinton agar, and the colonies were counted after 18 h of incubation at 37°C. Results: The minimal inhibitory concentrations of the antibiotics in the SF6 group were found to be identical with those of the control group. However, the minimal bactericidal concentrations of the antibiotics were found to be at least two dilutions lower in the SF6 group than in the control group, except for the minimal bactericidal concentration of cefazolin for S. aureus, which was found to be one dilution lower in the SF6 group. Conclusion: SF6 was found to potentiate the in vitro antibacterial activity of ofloxacin and tobramycin against S. aureus, S. epidermidis and P. aeruginosa, ceftazidime against P. aeruginosa, and cefazolin against S. epidermidis. Experimental animal studies are required to determine the role of SF6 in the management of endophthalmitis.
Risk Factors for the Development of Bladder Transitional Cell Carcinoma following Surgery for Transitional Cell Carcinoma of the Upper Urinary Tract
Authors: Koga Fumitaka , Nagamatsu Hideki , Ishimaru Hisashi , Mizuo Toshiyuki , Yoshida Ken-ichiro
Published: April 2003

To determine the risk factors for development of transitional cell carcinoma (TCC) of the bladder (BTCC) following surgery for TCC of the upper urinary tract (UUT-TCC) in patients without history of BTCC, 85 patients surgically treated for UUT-TCC (34 female, 51 male; median age 66, range 42–85 years) were reviewed retrospectively. The Cox proportional hazards model was used to assess the association of relevant clinicopathologic factors with BTCC-free survival in patients without a history of BTCC and TCC-specific survival in all. Median follow-up duration was 35 (range 1–193) months. Six patients (7%) had previous histories of BTCC, and 6 others (7%) had concurrent BTCC at the time of surgery for UUT-TCC. Of 70 patients who had no history of BTCC and underwent follow-up cystoscopy, 24 (34%) developed BTCC during follow-up after surgery. Univariate analysis identified female sex, postoperative systemic chemotherapy, and incomplete distal ureterectomy as significant risk factors for new development of BTCC. After multivariate analysis adjusted for age and pathological (p) T stage in the TNM classification, all three factors remained significant, with respective hazard ratios of 5.56 (95% confidence interval (CI), 1.99–15.6; p = 0.001), 3.19 (95% CI, 1.34–7.62; p = 0.009) and 2.99 (95% CI, 1.08–8.26; p = 0.03). Only pT stage was a significant independent risk factor for TCC-specific death. Female sex and postoperative systemic chemotherapy, as well as incomplete distal ureterectomy, are possible riks factors for development of BTCC following surgery for UUT-TCC.
Axonal Patterns in the Prosencephalon of the Human Developing Brain
Authors: Ulfig Norbert , Chan Wood Yee
Published: April 2003

In the second half of gestation the human fetal brain is characterized by prominent transient structures, i.e. subplate, ganglionic eminence and perireticular nucleus. These structures are involved in the formation of projections by acting as intermediate targets. This study is aimed at demonstrating axonal patterns and their reorganization in the human fetal brain using the antibody mixture SMI 312 which immunolabels phosphorylated neurofilaments predominantly found in axons. In the immunosections, a laminar- and nuclear-specific labeling is present. The subplate contains diffusely arranged fibers and conspicuous obliquely oriented fibers. The internal capsule harboring the perireticular nucleus is characterized by dense fiber clusters which display interwoven fibers at high magnification. Near the ganglionic eminence, fibers are seen that are directed towards its periphery. The latter, i.e. the margins of the ganglionic eminence, display fiber terminations. The results demonstrate characteristic transient axonal patterns which are linked to transient projections known from animal studies. It is obvious that the functional organization of the fetal brain distinctly differs from that of the mature brain.
Differential Expression Profile of Class I and Class III Metabotropic Glutamate Receptors during Postnatal Development of Rat Hippocampus
Authors: Scheiwe Christian , Normann Sabine , Blümcke Ingmar
Published: April 2003

The expression profile of neurotransmitter receptors changes significantly during brain development. In particular, the postnatal regulation of glutamate receptor expression may play a critical role in synaptogenesis, formation of neuronal circuitries and neuronal vulnerability. In this study, we have analyzed the mRNA expression profile of excitatory class I metabotropic glutamate receptors (mGluR) mGluR1 and mGluR5 as well as the inhibitory class III receptors mGluR4 and mGluR7 during postnatal hippocampal development in the rat using a competitive RT-PCR assay. A transient upregulation was observed for mGluR1 with a peak expression at postnatal day 30. The expression for mGluR4 and mGluR5 continuously declined during postnatal maturation (postnatal days 4–90). In contrast, the decline of mGluR7 expression was less substantial in this period. This divergent pattern of mGluR gene expression during postnatal development of the hippocampus may correspond to neuronal pattern formation and plasticity, but may also provide a molecular basis for altered seizure susceptibility and neuronal vulnerability in the developing rat hippocampus.
White Matter Changes and Poststroke Dementia
Authors: Leys Didier , Hénon Hilde , Pasquier Florence
Published: April 2003

Stroke patients are more likely to have white matter changes than age- and sex-matched controls. White matter changes are associated with an increased risk of dementia occurring after stroke: they often indicate a higher risk of stroke recurrence and they may lead to slight cognitive impairment. Besides white matter changes, vascular lesions of the brain and associated Alzheimer pathology, the summation of 2 or 3 of these mechanisms may lead to dementia in stroke patients even when each type of lesion is not severe enough to induce dementia by its own.
Propentofylline in the Treatment of Alzheimer’s Disease and Vascular Dementia: A Review of Phase III Trials
Authors: Rother Matthias , Erkinjuntti Timo , Roessner Martin , Kittner Barbara , Marcusson Jan , Karlsson Ingvar
Published: April 2003

Propentofylline, a neuroprotective glial cell modulator, has been shown in preclinical studies to address some of the common pathological processes of Alzheimer’s disease (AD) and vascular dementia (VaD), including glial cell activation and increased production of cytokines, free radicals, and glutamate. To examine whether propentofylline (300 mg t.i.d. taken 1 h before meals) would provide beneficial effects in patients with AD and/or VaD, 901 patients with mild-to-moderate AD and 359 patients with mild-to-moderate VaD were enrolled in four double-blind, placebo-controlled, randomized studies ranging in duration from 6 months to 56 weeks. Propentofylline was found to provide consistent improvements over placebo in efficacy assessments for both AD and VaD patients. In addition, results from a drug withdrawal study suggested that propentofylline does not merely relieve dementia symptoms but slows the progression of the disease itself. Propentofylline had a good safety profile and was generally well tolerated.
The Bayer Activities of Daily Living Scale (B-ADL)
Authors: Hindmarch Ian , Lehfeld Hartmut , de Jongh Perry , Erzigkeit Hellmut
Published: April 2003

The Bayer Activities of Daily Living Scale (B-ADL) has been developed on an international basis to assess deficits in the performance of everyday activities. The scale’s main target group is community dwelling patients who suffer mild cognitive impairment or mild-to-moderate dementia. It comprises 25 items and takes the form of a questionnaire to be completed by a caregiver or other informant sufficiently familiar with the patient. Statistical, clinical and domain-related criteria were used to select items from among a large number of activities of daily living (ADL) questions field tested in pilot studies in the USA, Germany, UK, Russia and Greece. The items included in the B-ADL have been chosen for their sensitivity to cognitive impairment, simplicity of concept, international applicability and their relevance to patients coping with the demands of everyday life. The scale uses items which reflect a wide range of domains. On account of its brevity, it is thought especially suitable for application within a GP and primary care context for both screening a patient’s ADL capacities as well as for documentation of treatment effects and the progress of dementia. This paper focuses on a description of the scale and its application.
Cognition, Language and Behaviour in Motor Neurone Disease: Evidence of Frontotemporal Dysfunction
Authors: Bak Thomas H. , Hodges John R.
Published: April 2003

Cognitive symptoms accompanying motor neurone disease (MND) have been recognized and described since the late 19th century. Numerous reports from Europe, North America and Japan suggest existence of a syndrome that can be described as MND/dementia. Typically, psychiatric and cognitive changes, strongly reminiscent of frontotemporal dementia, precede the occurrence of the classical signs and symptoms of MND by several months. In a small number of patients a similar picture can be heralded by a progressive aphasia leading ultimately to mutism. While the syndromes of MND/dementia and MND/aphasia constitute a comparatively small group, subtle but consistent cognitive alterations have also been observed in the majority of nondemented MND patients. Although generally much less pronounced, their pattern, affecting mostly frontal-executive functions, resembles that of MND/dementia. Postmortem examination results, describing pathological changes in the frontal lobes, and functional neuroimaging studies, showing abnormal pattern of frontal activation, add more weight to the hypothesis linking MND to the frontotemporal dementia.