bluuebunny/crossref_metadata_2025 huggingface dataset:
Four years experience of first‐trimester nuchal translucency screening for fetal aneuploidies with increasing regional availability
Authors: Wayda Kornélia , Keresztúri Attila , Orvos Hajnalka , Horváth Emese , PÁl Attila , Kovács LÁszló , Szabó JÁnos
Published: March 2003

Background. A prospective screening study was carried out at the regional genetic and perinatal center in South Hungary in order to determine the efficiency of first‐trimester nuchal translucency screening for fetal aneuploidies, following augmentation of the availability of nuchal translucency screening in the region by the inclusion of newly‐trained hospital sono‐graphers.

Methods. Nuchal translucency thickness was measured by transvaginal sonography in 7,044 women with singleton or multiple pregnancies at weeks 10–12. Fetal karyotyping was performed when the nuchal translucency was ≥2.5 mm, and in women with fetuses at high cytogenetic risk.

Results. Follow‐up was performed in 6,841 of the 7,044 screened women. An abnormal karyotype was found in 33 cases (0.48%). The level of increased nuchal translucency was 4.5% at a cutoff of ≥2.5 mm, and 2.8% at a cutoff of ≥3 mm. Seventeen cases of trisomy 21, eight of trisomy 18, four of trisomy 13, one of 45,X, one of triploidy and two cases with other chromosomal abnormalities were detected. In the 33 fetuses with a chromosomal abnormality, the nuchal translucency thickness was <2.5 mm in a case of trisomy 18, ≥2.5 mm in 32 cases and ≥3 mm in 28 cases. With cutoffs of 2.5 mm and 3 mm, the sensitivity was 96.97% and 84.85%, respectively.

Conclusions. Application of a nuchal translucency thickness cutoff of 2.5 mm is highly efficient for the screening of fetal aneuploidies at 10–12 weeks. This efficiency can be maintained by increasing the regional availability of nuchal translucency screening through the inclusion of newly‐trained hospital sonographers.
Is 24‐h sperm motility a useful IVF measure when male infertility is not apparent?
Authors: Eskandar Mamdoh
Published: March 2003

Objective.  To examine the relationship of 24‐h sperm motility between post insemination and fertilization in vitro, in a population with no apparent semen abnormalities. A retrospective study from July 1998 to June 2000.

Material and methods.  Four hundred and seventy‐one consecutive in‐vitro fertilization (IVF) cycles for which the primary diagnosis was not male infertility (total motility count > 40 × 106) were studied. Linear regression was used to examine the general relation between 24‐h sperm motility and IVF. The cohort with 0% 24‐h motility was compared with all other cycles using the t‐test and the χ2‐test. Test quality was assessed using the positive likelihood ratio.

Results.  Overall fertilization was 58 ± 16%. There were 45/471 cycles (9.5%) with zero fertilization. Linear regression of percent fertilization vs. 24‐h motility showed no relationship (r = 0.01). The cohort with 0% 24‐h motility had a lower fertilization rate 29 ± 19% (P = 0.05), and had a higher incidence of no fertilization 7/21 (P = 0.01). The positive likelihood ratio was 4.6.

Conclusions.  Zero 24‐h motility indicates occult male infertility, and a positive result indicates a fair to good test. Overall there was no relationship between sperm survival at 24 h post insemination and fertilization in vitro. However, 0% 24‐h sperm motility was associated with reduced fertilization
Recurrent cervical cancer: detection and prognosis
Authors: Duyn Annette , Van Eijkeren Marion , Kenter Gemma , Zwinderman Koos , Ansink Anca
Published: March 2003

Background.  Only a small proportion of cervical cancer recurrences is detected during routine follow‐up. We investigated which percentage of recurrences is detected during follow‐up, which diagnostic tools are helpful to detect recurrent disease and which factors are of prognostic significance once recurrent disease has been established in patients treated for cervical cancer stage IB–IVA.

Methods.  Characteristics of the primary tumor, characteristics of recurrent disease and follow‐up were collected retrospectively from clinical records of 277 patients who achieved a complete remission of at least 3 months after primary treatment for cervical cancer in 1992, 1993 and 1994 in three university hospitals in the Netherlands.

Results.  Of 277 patients, 47 (17%) developed recurrent disease; this was most often detected after self‐referral (45%), and in 32% during routine follow‐up. Survival did not differ significantly between these two groups. The presence of symptoms (87%) was the most important first abnormal test result leading to diagnosis of recurrence. In univariate analysis, disease‐free interval (DFI) and treatment modality were significant prognostic factors for crude survival of recurrence. However, treatment modality varied considerably and the subgroups were small. Therefore, multivariate analysis was not feasible and clinically valid conclusions could not be drawn.

Conclusions.  In only 32% of all cases, recurrence was detected during a scheduled follow‐up visit. In the majority of patients, recurrent cervical cancer was detected by symptoms (87%). In recurrent disease, DFI was a prognostic factor for survival.
Accuracy of fetal pulse oximetry
Authors: Luttkus Andreas K. , Lübke Marion , Büscher Ulrich , Porath Martina , Dudenhausen Joachim W.
Published: March 2003

Background. The goal of this investigation was to evaluate the agreement of fetal pulse oximetry to saturation readings from hemoximetry at low oxygen saturation.

Methods. Fetal oxygen saturation measurements obtained by pulse oximetry were compared with those obtained by hemoximetry in fetal scalp blood samplings. The prospective observational trial included fetuses with non‐reassuring fetal heart rate tracings suggestive of hypoxia and requiring fetal scalp blood samplings. Arterial oxygen saturation was determined by a blinded pulse oximeter (N400, FS14; Nellcor Puritan Bennett, Pleasanton, CA, USA) and continuously stored on a notebook computer. Saturation from fetal scalp blood samples was measured by hemoximetry (Bayer Diagnostics 865; ABL 625, Radiometer). Data analysis focussed on the absolute and relative difference between hemoximetry and pulse oximetry of fetuses, showing the most distinct difference in neonatal outcome. Normal outcome was defined as spontaneous delivery and umbilical artery pH ≥ 7.20 + Apgar 5 ≥ 7 (n = 42). In contrast, a group of neonates with combined respiratory and metabolic acidemia at birth was defined by pH ≤ 7.16 and an additional base excess ≤ −9.4 mmol/l in the umbilical artery (n = 18).

Results. The correlation coefficient between hemoximetry and pulse oximetry measurements was r = 0.72; p = 0.002 in the acidemic group. The median of absolute differences in saturation was + 5.2% (95%CI 2.5–10.3) saturation. The absolute differences ranged from −21% to + 36% saturation. The median of relative differences amounted to 23% (95%CI 15.1–55.0). The relative differences ranged from −30% to + 217%. Observing the saturation distribution in the two groups (hemoximetry and pulse oximetry, respectively) presented a median hemoximetry pulse oximetry of 38% (42%) in the normal and 26% (39%) in the acidemic group. In this small group of cases, the correlation coefficient between pH and saturation from pulse oximetry in fetal scalp blood from the samplings was r = 0.19.

Conclusion. Fetal pulse oximetry tends to overestimate arterial oxygen saturation compared with hemoximeter values.
Self‐reported reproductive outcome and implications in relation to use of care in women in rural Zimbabwe
Authors: Nilses Carin , Nyström Lennarth , Munjanja Stephen , Lindmark Gunilla
Published: March 2003

Background. In order to assess morbidity and health care utilization in developing countries, health interview surveys are often used. The aim of this paper is to explore morbidity, health care utilization during pregnancy and pregnancy outcome as reported by women in rural Gutu district, Zimbabwe.

Methods. The study was cross‐sectional, performed 1992–93 in 12 villages selected at random. Women aged 15–44 years (n = 1213) were interviewed concerning their reproductive history, use of maternity care and complications during pregnancy/labor during their latest pregnancy.

Results. The perinatal mortality rate (PMR) for all the completed pregnancies (889 women had completed 3601 pregnancies) was 23/1000 total births. The attendance rate for antenatal care was high (94%). Elevated blood pressure was the most commonly reported late pregnancy complication, and a prolonged labor, i.e. 24 h or more, the most common complication during delivery. Out of women whose latest pregnancy did not end in an early or late abortion (n = 831) the cesarean section rate was 6.3%. The PMR was 8.4/1000 for their latest pregnancy. Institutional deliveries were preferred by the majority of women, with hospital and clinic deliveries constituting 58% and 27% of deliveries, respectively, while 15% delivered at home. Long‐term complications were few, and only 14 (1.6%) women reported a current health problem, which they related to previous pregnancies.

Conclusions. Antenatal attendance rate was high. The majority of women preferred institutional deliveries. Few women reported complications, which were not taken care of in the health service. Long‐term complications related to previous pregnancies were few.
Pregnancy outcome after suicide attempt by drug use: a Danish population‐based study
Authors: Flint Carolin , Larsen Helle , Nielsen Gunnar Lauge , Olsen Jørn , Sørensen Henrik Toft
Published: March 2003

Background. It is important to study the side‐effects of drugs taken during pregnancy, however the findings are difficult to interpret because of a low exposure level, uncertainty of actual drug consumption and confounding by indication. Experience from accidental or intended drug intoxications may bypass some of these methodological shortcomings. Our aim was to examine reproductive failures and child health following a single drug overdose taken prior to or during pregnancy.

Methods. Women diagnosed with a drug intoxication during pregnancy were identified in the Regional Hospital Discharge Registry of North, Jutland from 1977 to 1999 by linkage of diagnoses for abortion and delivery with diagnoses for intoxication. Hospital medical records were reviewed to obtain data on drug use, dosage, and pregnancy outcome (legally induced abortion/miscarriages/data on birth outcome). The hospitalization history of the children was followed for a mean of 9 years with a maximum of 20 years.

Results. Of 122 women studied, 44 wanted an elective abortion, 17 experienced miscarriage, and 61, exposed mainly to weak analgesics and psychotropic drugs, gave birth to 62 infants. We estimated the proportion of miscarriage to be almost doubled, whereas there was no increased risk of congenital abnormalities or prematurity in women exposed to a drug overdose compared with the background population.

Conclusions. A drug overdose shortly before or during pregnancy seems to be associated with a substantially increased risk of miscarriage, but there was no increase in fetal pathology at birth among fetuses surviving till birth.
Statistical techniques for the analysis of change in longitudinal studies of the menopause
Authors: Lehert P. , Dennerstein L.
Published: March 2003

Objective. Critical review of statistical techniques used to analyze data from longitudinal studies.

Method. Literature search and classification of statistical methods and their utilization evaluated against known underlying assumptions.

Results. One hundred and twenty‐three papers found:

1. cross‐sectional reduction of data (56%);

2. multifactorial techniques (26%);

3. repeated measurement analysis of variance (14%);

4. other (time series and structural equation modelling) (4%).

Conclusions. Cross‐sectional reduction violates underlying statistical assumptions. A simple and powerful technique is to mean values prior to and following an event such as the final menstrual period. To allow for the influence of multiple factors, linear regression is preferred to logistic regression where continuous data are available. For more information about evolution in time, more complex techniques are needed. A suitable technique is repeated measurement multivariate analysis of variance using a number of contrasts to estimate various effects. Split plot or randomized block designs cannot be recommended as they violate compound symmetry assumptions. For series involving more than 100 observations for each subject, time series and spectral analysis techniques should be considered. Structural equation modelling is recommended for examination in detail of a range of factors that may influence the studied end‐point, the presence of feedback and of latent or non‐measurable variables.
Could an infectious trigger explain the differential maternal response to the shared placental pathology of preeclampsia and normotensive intrauterine growth restriction?
Authors: Von Dadelszen Peter , Magee Laura A.
Published: March 2003

Preeclampsia/eclampsia remains an important cause of maternal and perinatal morbidity and mortality. Its origins lie in a mismatch between fetoplacental demands and the ability of the uteroplacental arteries to supply those demands, a situation that also arises in normotensive intrauterine growth restriction (the fetal syndrome of preeclampsia in isolation). Why is there this differential response to the same underlying pathology? This review summarises the evidence surrounding a potential trigger for the differential response, namely infection. This builds on the inflammatory model of preeclampsia for which there is increasing support. The evidence for an infectious trigger is principally indirect, linking the similarities between acute atherosis in preeclampsia and atherosclerosis, the increased likelihood of developing cardiovascular disease later in life following a preeclampsia pregnancy, and the association between chronic infection and atherogenesis. Also reviewed is the human and animal model evidence for an infectious trigger for preeclampsia. Perhaps preeclampsia truly is the ‘toxemia’ of pregnancy.
Do occult anal sphincter injuries, vector volume manometry and delivery variables have any predictive value for bowel symptoms after first time vaginal delivery without third and fourth degree rupture? A prospective study
Authors: Nazir Mohammad , Carlsen Erik , Nesheim Britt‐Ingjerd
Published: March 2003

Background.  The aim of this study was to determine whether there exists a correlation between anal incontinence, occult sphincter injuries, anal manometry values, and delivery variables in primiparous women after first time vaginal delivery.

Methods.  Eighty‐six primigravida women were recruited for this study. Transanal ultrasonography (TAUS) and vector volume manometry (VVM) was performed and bowel symptoms were recorded at 25 weeks of pregnancy and 5 months after labor. Incontinent women at 5 months after vaginal delivery were interviewed again at 12 months.

Results.  Nineteen women (25%) experienced flatus incontinence postpartum. After 12 months, only one‐third of the women were still incontinent. Fourteen women (19%) showed abnormal TAUS of the anal sphincter. Of the delivery variables, only baby head circumference was significantly associated with flatus incontinence (p = 0.01). There was no correlation between flatus incontinence or delivery variables and anal sphincter injuries; VVM values were not associated with either anal sphincter injuries or flatus incontinence at 5 months, but VVM values were negatively associated with flatus incontinence at 12 months after labor.

Conclusions.  At 5 months after labor, flatus incontinence is relatively common, and is not associated with reduced VVM values. Two‐thirds of women recover from flatus incontinence during the first year. Women who had flatus incontinence persisting for a minimum of 1 year had reduced VVM values. Anal sphincter injuries as seen by TAUS are not associated with either VVM values or any delivery variable. Baby head circumference is the only delivery variable significantly associated with flatus incontinence.
Expression of the vascular endothelial growth factors B and C and their receptors in human endometrium during the menstrual cycle
Authors: Möller Björn , Lindblom Bo , Olovsson Matts
Published: March 2003

Background.  Endometrial angiogenesis is important for bleeding control and fertility, and is believed to be regulated by angiogenic growth factors under the influence of ovarian steroids.

Objective.  To document the pattern of expression of the two angiogenic growth factors, vascular endothelial growth factor (VEGF)‐B and VEGF‐C, and of their receptors, VEGFR‐1, VEGFR‐2, and VEGFR‐3, in order to investigate their possible role in the regulation of angiogenesis in normal cycling human endometrium.

Material and methods.  Cryosections of endometrial biopsy specimens obtained from 17 healthy women before laparoscopic sterilization were examined by immunohistochemistry.

Results.  Vascular endothelial growth factor and VEGF‐C and their receptors were all expressed in and around endometrial blood vessels, with no obvious menstrual cycle‐dependent changes in expression except for VEGFR‐2, which showed stronger expression during the early secretary phase. Stromal blood vessel density did not change significantly during the menstrual cycle.

Conclusion.  The presence and pattern of expression of these angiogenic growth factors and their receptors suggest that they participate in the regulation of normal endometrial angiogenesis.
Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies
Authors: Tsunoda Tetsuo , Ohkuchi Akihide , Izumi Akio , Watanabe Takashi , Matsubara Shigeki , Sato Ikuo , Minakami Hisanori
Published: March 2003

Background.  It is not known whether antithrombin III activity and platelet count are more likely to decrease in women with twin pregnancies than singleton pregnancies.

Methods.  We enrolled 56 consecutive women with twin pregnancies and 692 consecutive women with singleton pregnancies. Antithrombin III activity and platelet count were determined at 26–31 weeks and again at 32–40 weeks of gestation. Thrombin–antithrombin complex, and plasmin–α2 plasmin inhibitor complex were measured simultaneously in some women.

Results.  In twin pregnancies, both antithrombin III activity (111 ± 8.2%) and platelet count (244 ± 60 × 109/l) at 28.6 ± 1.0 weeks decreased over time to 91 ± 12% and 205 ± 59 × 109/l, respectively, at 35.2 ± 1.2 weeks; these decreases were significantly greater than in singleton pregnancies. However, a small number of women with singleton pregnancies had a significant decrease in antithrombin III activity in the absence of preeclampsia. The serum thrombin–antithrombin complex was significantly higher in twin pregnancies than in singleton pregnancies (9.7 ± 4.2 ng/ml vs. 6.7 ± 4.4 ng/ml, respectively, p < 0.01), and this increase correlated significantly with the decrease in antithrombin III activity in twin pregnancies (r = −0.459, p < 0.001).

Conclusions.  Antithrombin III activity and platelet count show a greater decrease in twin than in singleton pregnancies, perhaps due to a greater increase in thrombin generation.
Relationship between blood pressure level in early pregnancy and subsequent changes in blood pressure during pregnancy
Authors: Iwasaki Ryuhiko , Ohkuchi Akihide , Furuta Itsuko , Ojima Toshiyuki , Matsubara Shigeki , Sato Ikuo , Minakami Hisanori
Published: March 2003

Background.  It is not known whether women with high blood pressure in the first trimester are likely to exhibit a large increase in blood pressure during pregnancy.

Methods.  We conducted a retrospective, longitudinal study of 1599 pregnant women, among whom 29 women (1.8%) received antihypertensive medication during pregnancy. The blood pressure levels measured during the first (7.9 ± 2.4 weeks), second (20.7 ± 1.2 weeks) and third trimesters (38.4 ± 1.7 weeks) were analyzed. The obstetric outcomes were examined in five subgroups divided according to the quintile of the first‐trimester mean arterial pressure level.

Results.  The net change in blood pressure levels (third‐trimester value minus first‐trimester value) was significantly inversely correlated with the first‐trimester blood pressure levels irrespective of the use or lack of use of antihypertensive drugs. Women with the highest quintile first‐trimester mean arterial pressure had the largest body weight, exhibited a fall in blood pressure and had the smallest increase in body weight during pregnancy, and were significantly more likely to have a growth‐restricted infant.

Conclusions.  Women with high initial blood pressure tended to exhibit a fall in blood pressure, whereas women with low initial blood pressure tended to exhibit a large increase in blood pressure during pregnancy. Women with high initial blood pressure and a small increase in body weight during pregnancy tended to have growth‐restricted infants.
Image analysis to improve diagnosis of exfoliation
Authors: Puska Päivi , Sassi Raija , Tarkkanen Ahti
Published: March 2003

Purpose: To improve visualization of exfoliation material in standard colour photographs by image analysis.

Methods: Standard anterior segment colour photographs taken from 17 patients with known exfoliation were subjected to film scanning with a maximum accuracy of 3175 dpi.

Results: Before image scanning, visualization of exfoliation was classified as barely visible in 10 (59%) patients and clearly visible in 7 (41%) patients. After the image scanning, exfoliation material became clearly visible in 13 (76%) patients and could easily be demonstrated.

Conclusion: Diagnosis of exfoliation material can be improved by standard film scanning.
Tumors and pseudotumors of the optic disc
Authors: Shields Jerry A.
Published: March 2003

ABSTRACT. There are many lesions that can present as an elevation of the optic disc. Since each of them has different ophthalmic and systemic significance, it is important for the ophthalmologist to recognize them and to plan strategies of management when necessary. Important inflammatory and benign congenital conditions should be differentiated from malignant neoplasms. This review covers the differential diagnosis of lesions that can cause an elevation of the optic disc. It includes selected congenital lesions, inflammatory conditions, non‐inflammatory non‐neoplastic disorders, benign hamartomas, and primary and secondary malignant neoplasms.
Central serous chorioretinopathy following pigment epithelium detachment: fluorescein and indocyanine green angiography follow‐up
Authors: Gómez‐Ulla Francisco , Vázquez José Manuel , Rodríguez‐Cid María José , Des Julio , González Francisco
Published: March 2003

Purpose: To evaluate the evolution from idiopathic serous pigment epithelium detachment (PED) to central serous chorioretinopathy (CSC).

Methods: Fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed using the digital imaging system Topcon IMAGEnet H 1024.

Results: A leakage point which later became the typical smokestack image of a CSC was found in the upper margin of the persistent PED. Dilation of the choroidal vessels under the detached neuroepithelium was also seen.

Conclusions: Clinical and angiographic evidence about the relation betweeen the two entities can help us to understand CSC as a potential evolution of PED and to continue searching for the common injury of the pigment epithelium which probably is the primary event.
Screening and prevention of diabetic blindness
Authors: Stefánsson Einar , Bek Toke , Porta Massimo , Larsen Nikolaj , Kristinsson Jóhannes Kári , Agardh Elisabet
Published: March 2003

: Diabetic eye disease remains a major cause of blindness in the world. Laser treatment for proliferative diabetic retinopathy and diabetic macular edema became available more than two decades ago. The outcome of treatment depends on the timing of laser treatment. The laser treatment is optimally delivered when high‐risk characteristics have developed in proliferative retinopathy or diabetic macular edema and before this has significantly affected vision. Laser treatment is usually successful if applied during this optimal period whereas the treatment benefit falls sharply if the treatment is applied too late.

In order to optimize the timing of laser treatment in diabetic eye disease screening programs have been established. The oldest screening program is 20 years old and several programs have been established during the last decade. In this paper the organisation and methods of screening programs are described including direct and photographic screening. The incidence and prevalence of blindness is much lower in populations where screening for diabetic eye disease has been established compared to diabetic populations without screening. Technical advantages may allow increased efficiency and telescreening.

From a public health standpoint screening for diabetic eye disease is one of the most cost effective health procedures available. Diabetic eye disease can be prevented using existing technology and the cost involved is many times less than the cost of diabetic blindness.
Diclofenac drops to treat inflammation after cataract surgery
Authors: Herbort Carl P. , Jauch Arthur , Othenin‐Girard Philippe , Tritten Jean‐Jacques , Fsadni Mario
Published: March 2003

Purpose: To compare the anti‐inflammatory effect of topical diclofenac sodium 0.1% in a fixed combination with gentamicin 0.3% to the anti‐inflammatory effect of dexamethasone phosphate 0.1% in a prospective randomized double‐masked double‐dummy study in patients undergoing cataract surgery.

Setting: Trial performed from June 1991 to April 1992 at the Hôpital Jules Gonin, Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland.

Methods: Inclusion of patients scheduled for extracapsular cataract extraction (ECCE) with implantation of an all PMMA intraocular lens (IOL). Double‐masked comparison of post‐operative inflammation in two randomized treatment groups: (1) fixed diclofenac sodium 0.1%/gentamicin 0.3% and vehicle drops 4X/day until day 12–14 and diclofenac sodium 0.1% 3X/day until day 28. (2) dexamethasone phosphate 0.1% drops 4X/day until postoperative day 12–14 and 3X/day until day 28 and gentamicin 0.3% drops 4X/day until day 12–14. Anterior chamber flare and cells, measured by laser flare‐cell photometry, were analyzed as the primary outcomes.

Results: Eighty‐seven patients were recruited, 45 being assigned to the diclofenac group and 42 to the dexamethasone control group. Diclofenac was significantly better than dexamethasone at controlling flare at day 3 (p≤0.01) and day 12–14 (p≤0.002). Mean anterior chamber cells were also significantly lower at day 12–14 (p≤0.021) and day 28 (p≤0.012). The commonest adverse event was transient punctate keratitis, which occurred in 15 diclofenac and 3 dexamethasone patients.

Conclusions: While both treatments were effective at controlling post‐operative inflammation, the diclofenac‐gentamicin combination followed by diclofenac alone was significantly better at suppressing flare and cells but showed a slightly higher incidence of punctate keratitis and eye discomfort.
The luminance fall in anomaloscope examination: clinical examples
Authors: Pinckers Alfred , Uvijls André
Published: March 2003

Purpose: The evaluation of the anomaloscope slope quotient in patients with acquired colour vision deficiency.

Methods: Two patients with Stargardt's disease in combination with protanomaly and deuteranomaly, respectively, were selected and also 3 patients with a presumed dominant optic atrophy of the protan type. The anomaloscope examination was performed according to the Linksz procedure. The luminance fall was calculated as the slope quotient SQ:Y units luminance fall per X units width of the matching range.

Results: The SQ of the 2 Stargardt patients was steeper than the SQ of congenital colour vision defectives, especially at the red end of the anomaloscope green‐red mixture scale, indicating pathologic scotopization superimposed on the congenital deficiency. In optic atrophy of the protan type the SQ was flatter than in congenital deficiency, indicating that this deficiency has nothing to do with congenital protan deficiency.

Conclusion: Calculation of the slope quotient SQ is helpful for the diagnosis of acquired colour vision deficiency, especially when the subject also has a congenital colour vision deficiency or is supposed to have such a deficiency.
Search for autoantibodies against the HNK‐1 carbohydrate epitope in the human eye in intermediate uveitis
Authors: Uusitalo Marita , Mikkilä Helena , Karma Anni , Kivelä Tero
Published: March 2003

Purpose: Molecules bearing the immunogenic HNK‐1 epitope are present in the inner connective tissue layer and epithelia of the ciliary body. We investigated whether autoantibodies to these molecules can be detected in patients with intermediate uveitis, which affects the ciliary body.

Methods: Serum was collected from 9 patients with intermediate uveitis, and from 6 controls with idiopathic iritis and 3 controls with sarcoid uveitis, representing nongranulomatous and granulomatous uveitis, respectively. The sera were used as polyclonal antibodies to immunostain 3 formalin‐fixed, paraffin‐embedded normal human donor eyes by the avidin‐biotinylated peroxidase complex method.

Results: No immunostaining in the ciliary body could be detected using the sera from patients with intermediate uveitis or from the controls. Serum within blood vessels was nonspecifically immunolabelled with the secondary anti‐human antiserum.

Conclusion: No autoantibodies against the HNK‐1 epitope or other antigens of the ciliary body could be demonstrated in patients with intermediate uveitis. It is unlikely that such autoantibodies against the HNK‐1 epitope have a role in intermediate uveitis.
Secondary glaucoma in patients with juvenile rheumatoid arthritis‐associated iridocyclitis
Authors: Foster C. Stephen , Havrlikova Katerina , Baltatzis Stefanos , Christen William G. , Merayo‐Lloves Jesus
Published: March 2003

Purpose: The prevalence and management of glaucoma were evaluated in patients with juvenile rheumatoid arthritis (JRA)‐associated iridocyclitis.

Methods: The records of 69 patients with JRA‐associated iridocyclitis were reviewed.

Results: Twenty‐nine (42%) of these patients had secondary glaucoma or ocular hypertension. Glaucoma was controlled with topical treatment in only 7 of the 41 affected eyes (17%); systemic carbonic anhydrase inhibitor therapy resulted in control of another 8 eyes. Surgery controlled all but one of the remainder.

Conclusion: Glaucoma is a common complication of JRA‐associated iridocyclitis. It results from prolonged, inadequately treated intraocular inflammation and in some instances, from steroid use. Medical and surgical therapy for the glaucoma associated with JRA‐uveitis is challenging and incompletely effective. We suspect that a more aggressive approach to the treatment of JRA‐associated uveitis, earlier in the course of the disease may reduce this vision robbing contribution to the process.
Skin Tests and Cutaneous Anergy in Children with Ocular Allergy
Authors: Bremond‐Gignac Dominique , Beydon Nicole , Laroche Laurent
Published: March 2003

Purpose: To evaluate skin tests with clinical ocular allergy and to compare cutaneous hypersensitivity and seasonal allergic conjunctivitis in children.

Case‐report: A 10‐year‐old girl presented a typical seasonal allergic conjunctivitis, never treated and the onset occurred one year before. She was skin tested for the allergy. Complete blood tests were also performed. An ocular treatment was given: olopatadine over 45 days.

Results: She showed a complete cutaneous anergy including histamine and codeine controls. Radioallergosorbent tests (RAST) found numerous great positivity to different allergens. Within 30 days under ocular treatment, she recovered completely from symptoms and clinical signs.

Conclusion: Clinical typical seasonal ocular allergy in children with cutaneous anergy should be explored further or at least treated. Cutaneous hypersensitivity should be evaluated more precisely with a larger study comparing results in general allergy and in ocular allergy where the anergy seems to be more frequent.
Is it mandatory to treat amblyopia prior to surgery in esotropia?
Authors: Dadeya Subhash , Ms Kamlesh
Published: March 2003

ABSTRACT. Purpose: To determine whether presence of amblyopia has any influence on the outcome of motor and sensory success in cases of esotropia.

Methods: 100 patients were taken for this study. Patients were divided into two groups of 50 each. Amblyopia was fully treated in group I and patients in group II underwent surgery before full treatment of amblyopia. Motor success (±10 PD of orthophoria) was assessed three months after surgery and at the child’s most recent visit by comparing the motor alignment at 6 meter and 0.33 meter distance using accommodative target in primary position. Sensory success was assessed by comparing the frequency of detectable stereoacuity.

Results: There was no significant difference in motor success (84% vs 75%) and sensory success (55% vs 50%) whether amblyopia was fully treated or partially treated.

Conclusion: It is not mandatory to treat ambloypia prior to surgery, unless it is a case of infantile esotropia with moderate amblyopia and amblyopia therapy is continued post operatively.
Ocular complications of leprosy in Cameroon
Authors: Mvogo Côme Ebana , Bella‐Hiag Assumpta Lucienne , Ellong Augustin , Achu Joko Henry , Nkeng Protest Fonguazi
Published: March 2003

ABSTRACT. Purpose: This study aimed to identify the main ocular complications of leprosy in Cameroon.

Patients and Methods:

It is a prospective cross‐sectional study which took place from July 1998 to January 1999 in five leprosaria in Cameroon. The ophthalmological examination of all patients was performed by the same team.

Results: Of the 218 patients examined, 60.1% were males and 39.9% females. 72.5% had a paucibacillary leprosy and 27.5% a multibacillary form. 77.5% of patients had at least one ocular lesion and 38.3% of eyes had visual acuity ≤1/10. Madarosis and anterior uveitis were more frequent in multibacillary forms while lagophthalmos and cataract were so in paucibacillary forms.

Conclusion: Ocular complications are frequent in leprosy in Cameroonians. It is a true public health problem and it is important to prevent these lesions by early diagnosis and adequate treatment.
Exercise and iris concavity in healthy eyes
Authors: Haargaard Birgitte , Jensen Peter Koch , Kessing Svend V. , Nissen Ole I.
Published: March 2003

ABSTRACT. Purpose: To study the effect of exercise on the configuration of the anterior chamber angle in healthy persons.

Methods: Both eyes of 22 healthy persons were scanned by Ultrasound Biomicroscopy. Before and after 10 minutes of exercise the anterior chamber angle and the area of the peripheral anterior chamber were measured on the scannings.

Results: After exercise the anterior chamber angle/peripheral area increases in all eyes due to changes in the iris configuration. The myopic group shows the largest change.

Conclusion: Reverse pupillary block (iris concavity) is not pathognomonic in pigmentary glaucoma, it occurs in all normal eyes after exercise, most pronounced in myopics. Consequently, the difference between physiological and pathological reverse pupillary block has to be clarified.
Localised changes in glaucomatous visual fields after trabeculectomy
Authors: Vuori Marja‐Liisa , Vainio‐Jylhä Elina , Viitanen Tommi T.
Published: March 2003

Background and Objective: Modern techniques of automated perimetry have shown that surgical reduction of intraocular pressure (IOP) may have a beneficial effect on the glaucomatous visual field. The purpose of the present study was to analyse and quantify the changes in the visual fields of glaucoma patients after trabeculectomy.

Materials and Methods: Octopus visual fields of twenty‐seven glaucoma patients were analysed. Change in visual field mean sensitivity (MS) was calculated to detect total field changes. A clinical and a statistical analysis of small clusters of test points were used to define whether local changes had occurred.

Results: MS in the operated eyes improved significantly from 16.4±5.6 to 18.2±5.5 dB. The patients had on average 3.9±6.2 clusters where the retinal sensitivity had improved at least 5 dB and only 0.4±0.9 clusters where sensitivity had deteriorated at least 5 dB after trabeculectomy. 17 patients had more improved than deteriorated clusters postoperatively.

Conclusion: Statistically significant improvement was seen in the MS, but improvement was also found in small local areas of the visual fields after trabeculectomy.
Intraocular pressure over 24 hours after single‐dose administration of latanoprost 0.005% in healthy volunteers. A randomized, double‐masked, placebo controlled, cross‐over single center study
Authors: Larsson Lill‐Inger
Published: March 2003

Purpose: To measure the effect on intraocular pressure (IOP) over 24 hours after single‐dose administration of latanoprost 0.005%.

Patients and Methods: A randomized, double‐masked placebo‐controlled cross‐over study was carried out. Twenty healthy volunteers were randomly assigned to receive a single drop of latanoprost 0.005% or placebo, with a 2‐week wash‐out period before switching therapy. After hospitalization, the IOP was measured repeatedly over 24 hours, and again after 36 and 48 hours.

Results: The maximum IOP reduction for latanoprost occurred 12 hours after the dose with IOP 11.7±0.5 mmHg (least square mean±standard standard error of the mean [SEM]) for latanoprost and 13.5±0.5 mmHg for placebo. The difference of 1.8±0.6 mmHg was statistically significantly in favor of latanoprost (p=0.01; ANCOVA, confidence interval (CI) [−3.1; −0.5] mmHg). The average time to onset of action, defined as 50% of the maximal IOP reduction, was 6.0 hours for latanoprost. Latanoprost consistently reduced IOP over 24 hours after drop application with a difference in IOP reduction of 1.1±0.5 mmHg (p=0.03, CI [−2.1, 0.1]) at 24 hours. The corresponding IOP difference at 36 hours was 0.7±0.5 mmHg (p=0.20, CI [−1.7, 0.3]), and at 48 hours 0.8±0.5 mmHg (p=0.04, CI [−1.5, 0.0]).

Conclusions: Latanoprost applied as a single dose reduced IOP over 24 hours in healthy subjects compared with placebo. The IOP reduction was still present, however, less pronounced, 48 hours after drug application.
Histopathologically verified non‐vascular optic nerve lesions in Denmark 1940–99
Authors: Lindegaard Jens , Heegaard Steffen , Prause Jan Ulrik
Published: March 2003

Purpose: To evaluate the distribution in Denmark of histologically verified optic nerve lesions according to histological diagnosis, gender and age during a period of 60 years and to calculate frequency and possible changes in frequency during the observation period.

Methods:
All optic nerve lesions reported at the Eye Pathology Institute, University of Copenhagen, during the period 1940–99 were investigated. All similar lesions reported at all pathological departments in Denmark during 1974–99 were also investigated.

Results: The number of optic nerve lesions identified totalled 313 in 298 patients. The frequency of histopathological optic nerve lesions was seen to have increased significantly over the last 25 years, and at present, an average of 12 lesions per year are recorded. Lesions in children represented 42% (130). The percentage of lesions suffered by children remained constant throughout the observation period. Benign tumours constituted 33% (44) of the total number of tumours in adults and 61% (62) in children. Frequencies of glioma and optic nerve sheath meningioma increased significantly during the last 25 years. Subjects presenting with optic nerve sheath meningioma exhibited a significant difference in age at presentation: the mean age of women at presentation was seen to be 48.8 years, while the mean age of men at presentation was seen to be 29.7 years. The most frequent lesion seen in children was glioma and in adults invasion from malignant uveal melanoma.

Conclusion: Histologically diagnosed optic nerve lesions are rare and consist primarily of tumours. The increase in frequency of optic nerve lesions in Denmark during the last 25 years is due to an increase in the number of benign tumours.
Survival of transplanted human corneal stem cells. Case report
Authors: Stenevi Ulf , Hanson Charles , Claesson Margareta , Corneliusson Eva , Ek Stefan
Published: March 2003

Purpose:  To report a case history involving long‐term survival of transplanted human corneal stem cells.

Methods:  A male patient with severe bilateral chemical burns received six corneal transplants, all of which failed. He subsequently received combined corneal transplants and stem cell transplants, which have remained clear for 3 and 4 years respectively. One of the donors was female. We studied the gender of the epithelial cells of the cheek of the patient and of the two grafts using fixation and fluorescent in situ hybridization (FISH) analyses.

Results:  In the graft from the female donor, 30% of the epithelial cells were of female origin. All the epithelial cells from the cheek and the other graft were of male origin.

Conclusion:  This case demonstrates that transplanted human corneal stem cells can survive and replicate in the long‐term (3 years) without systemic immunosuppression. The case also indicates that a minority (30%) of healthy transplanted epithelial cells is enough to present a clear graft with a clinically healthy ocular surface.
Endophthalmitis following cataract surgery in Sweden.The 1998 national prospective survey
Authors: Montan Per , Lundström Mats , Stenevi Ulf , Thorburn William
Published: March 2003

Purpose: To investigate the morbidity of postoperative endophthalmitis (POE) following cataract surgery in Sweden in 1998.

Methods: Clinically presumed cases of POE were reported in a prospective survey in which all Swedish ophthalmic surgical units except one had agreed to participate. Data on intraocular cultures and visual outcomes at 3 months after infection were supplied. Surgical cases that became infected were identified in the Swedish National Cataract Register, thereby enabling screening for various putative risk factors.

Results: The nationwide incidence of POE amounted to 58 cases out of 54 666 cataract operations, or 0.1% of surgical cases. The predominant aetiology was gram‐positive bacteria, which comprised 57% of the material. Acrylic intraocular lenses were found to decrease the risk of POE significantly in comparison to hydrogel and polymethylmethacrylate lenses.

Conclusions: The incidence of POE after cataract surgery in Sweden is similar to that currently reported elsewhere in the developed world. We hope that continued registration of cases of POE in Sweden will shed light on the possible influences of various prophylactic measures and different intraocular lens materials on the development of postoperative infection.
Prevalence of refractive errors in young and middle‐aged adults in Norway
Authors: Midelfart Anna , Kinge Bettina , Midelfart Sven , Lydersen Stian
Published: March 2003

Purpose: To determine the prevalence of refractive errors in the young and middle‐aged adult population in Norway.

Methods: Refractive errors were measured in a population‐based sample of young (20–25 years) and middle‐aged (40–45 years) adults participating in the Helseundersøkelse i Nord Trøndelag (HUNT) Health Study, conducted in the County of Nord‐Trøndelag in Norway.

Results: A total of 3137 persons (1248 young and 1889 middle‐aged adults) with corrected visual acuity ≥ 0.5 (in either eye) were included in the study. The prevalence of myopia was 35.0% in the young adult group and 30.3% in the middle‐aged group. Myopia was significantly higher in women aged 20–25 years (36.4%) than in men aged 40–45 years (28.1%). Prevalence of hyperopia increased with age from 13.2% (20–25 years) to 17.4% (40–45 years). The highest rate of hyperopia (20.1%) was encountered in middle‐aged women.

Conclusion: The results show a slightly higher prevalence of myopia in the general population of Norway than previously estimated.
Dynamics of visual improvement following chiasmal decompression. Quantitative pre‐ and postoperative observations
Authors: Jakobsson Karl‐Erik , Petruson Björn , Lindblom Bertil
Published: March 2003

Purpose:  To study early visual restoration following surgical removal of pituitary adenomas compressing the optic chiasm.

Methods:  Eleven patients were examined with high‐pass resolution perimetry (HRP) before and after trans‐sphenoidal adenomectomy. Visual fields were examined on the second postoperative day. The result was interpreted in terms of the estimated fraction of functioning retino‐cortical connections.

Results:  In the upper and lower temporal visual field quadrants, the mean increases in the fraction of functioning neural channels were 19% (p < 0.001) and 17% (p = 0.001), respectively, on day 2 after surgery. These increased to 35% on day 12. The nasal hemifield showed no change on day 2, but functioning neural channels had increased by 15% on day 5 (p = 0.017). Mean visual acuity improved from 0.6 preoperatively to 1.0 on day 2 (p = 0.030) but did not change significantly thereafter.

Conclusion:  All visual field sectors and visual acuity improved after surgery. Improvement starting in the temporal hemifield was already evident on the second postoperative day.
Hyaline‐vascular type Castleman's disease involving both orbits
Authors: Park Keun‐Sung , Choi You‐Jin , Song Kyu‐Sang
Published: March 2003

Purpose: To describe a patient with hyaline‐vascular type Castleman's disease (CD) whose initial examination revealed only upper eyelid mass. Further, to review all aspects of CD.

Methods:  Case report. An 18‐year‐old woman initially presented with swelling of both upper eyelids. She underwent an anterior orbitotomy with surgical excision followed by close observation.

Results:  Histopathological examination of the upper eyelid mass confirmed the presence of hyaline‐vascular type CD. One year after surgical treatment, the patient is still asymptomatic, with no pathologic clinical or laboratory findings.

Conclusions:  Castleman's disease is a rare but valid clinical entity. It should be considered in the differential diagnosis of asymptomatic orbital mass. Our understanding of CD has advanced recently. The treatment modalities for CD (e.g. surgical excision, radiation therapy and combination chemotherapy) are usually curative and optimizing. Castleman's disease involving the orbital area is now attracting ophthalmological interest.
Castleman's disease in the orbit. A 20‐year follow‐up
Authors: Alyahya Ghassan Ayish , Prause Jan Ulrik , Heegaard Steffen
Published: March 2003

Purpose:  To report a case of localized orbital Castleman's disease of mixed cell type with a follow‐up of 20 years.

Methods:  A female patient presented at the age of 12 years with constitutional symptoms and left‐sided proptosis. Laboratory tests revealed marked hypergammaglobulinaemia and high erythrocyte sedimentation rate (ESR), suggesting an immunological disturbance. A CT scan and MRI showed an infiltrating orbital mass lateral to and behind the eye.

Results:  Histological examination of orbital biopsies showed a lymphoid lesion consistent with Castleman's disease of the mixed cell type. The patient was treated with systemic steroids, immunosuppressives and irradiation. She is now 33 years old and has been without relapse for the last 7 years.

Conclusion:  Orbital involvement in Castleman's disease is very rare. The clinical course, good prognosis and histological picture of the present case favour the diagnosis of localized Castleman's disease of mixed cell type. The successful medical treatment suggests that such a regime may substitute for surgery when the latter proves difficult.