Propionibacterium acnes in the cortex of patients with Alzheimer's disease

Propionibacterium acnes was found in the cortex of three patients with Alzheimer's disease and in one frontal cortex of an elderly patient with cardiovascular risk factors and hypoxia due to a large glioblastoma of the right frontal lobe with severely increased intracranial pressure. Propionibacterium acnes is an atypical anaerobic bacterium which is sensitive to cephalosporins, but insensitive to metronidazole. It is concluded that a capillary microangiopathy (in consequence of old age and cardiovascular risk factors such as high blood pressure) leads to cortical hypoxia and reduced resistance of the cortical immune system. Prevention by dietary regimes counteracting microangiopathy and treatment with cephalosporins are recommended.     

Results of the treatment of acute endophthalmitis after cataract surgery

Since 1980, the authors have observed 56 cases of endophthalmitis after cataract surgery which they classify into three groups: A. 18 cases of forms confined to the anterior segment, which just received medical treatment; B. 37 cases of more serious forms with vitreous abscess, treated by vitrectomy; C. 1 case of fulminant form which was eviscerated. The results of group B are better than those of group A: organic: 2.7% versus 11.1% of phtisis; functional: 73% of calculable visual acuity versus 66.6%, although the initial forms had been more severe. Vitrectomy, however causes some complications such as initial detachment (16.2%) cysto?d macular oedema (11%) and vascular complications (11%). However that may be, vitrectomy has several advantages: to collect a larger amount of vitreous liquid; to mechanically eliminate the pus; a faster functional rehabilitation by lightening of the vitreous.     

Results of bilateral cataract extraction with posterior chamber intraocular lens implantation in children

OBJECTIVE: A retrospective study was undertaken to evaluate long-term anatomic and visual outcomes in eyes of children who underwent bilateral intraocular lens implantation. DESIGN: The study design was a review of medical records of 24 children operated on for bilateral cataracts and posterior chamber-intraocular lenses. PARTICIPANTS: Twenty-four children operated on for bilateral cataracts by 1 surgeon between February 1980 and February 1995 were studied. INTERVENTION: Cataract extraction with bilateral posterior chamber-intraocular lens implantation was performed. MAIN OUTCOME MEASURES: Best-corrected visual acuity, visual acuity without correction, intraocular pressure, manifest refraction, and any intraoperative or postoperative complications were measured. RESULTS: At last follow-up (mean follow-up, 50.8 months; range, 10-149 months), the intraocular lens was in good position and the intraocular pressure was normal without medication in all eyes. Four years after surgery, 79.2% (19 of 24) of first eyes achieved a best-corrected visual acuity of 20/40 or better compared to 66.7% (16 of 24) of second eyes. No eye had any loss in best-corrected visual acuity. In first eyes of 3- to 8-year olds at the time of surgery, 73.3% (11 of 15) achieved a spherical equivalent within 2 diopters of the intended at 4 years after surgery compared to 80% of second eyes. In the 9- to 18-year-old group, 88.9% (8 of 9) of first eyes and 100% of second eyes achieved a spherical equivalent within 2 diopters of the intended at 4 years after surgery. Intraoperative and postoperative complications were minimal. CONCLUSIONS: Long-term anatomic and visual results have been gratifying in this series of patients with bilateral implants.     

Evaluation of intraocular pressure and cataract formation following the long-term use of nasal corticosteroids

It is possible that corticosteroids administered via nasal spray might reach ocular structures in levels sufficient to provoke an ocular hypertensive response and cause posterior subcapsular cataracts (PSCs) in susceptible individuals. In the present study, 26 patients who had undergone endoscopic sinus surgery were evaluated prospectively with respect to intraocular pressure and PSC formation following the use of nasal steroids for at least three months. Eighteen patients (69%) self-administered 200 micrograms/day of budesonide nasal spray twice daily, and eight patients (31%) self-administered 200 micrograms/day of beclomethasone dipropionate nasal spray twice daily, for a period of three to 19 months (mean 8.8 +/- 3.6 months). Ophthalmologic examination, tonometry, visual field testing and biomicroscopic studies revealed no evidence of ocular hypertension or PSCs during postoperative follow-up. We conclude that intranasal corticosteroids can be used safely for prolonged periods without increasing the risk of ocular hypertension or PSCs.     

Retinal detachment following intracapsular and extracapsular cataract extraction. A comparative, retrospective follow-up study

In a retrospective study we reviewed the post-operative incidence of retinal detachment in a consecutive series of 762 eyes operated on with intracapsular cataract extraction and a consecutive series of 1351 eyes operated on with extracapsular cataract extraction. Follow-up time was 2 1/2-4 1/2 years in both series. The incidence of retinal detachment was 0.79% after intracapsular cataract extraction and 0.44% after extracapsular cataract extraction. The difference was not statistically significant. Age below 70 years was not statistically significantly correlated to retinal detachment.     

Propionibacterium acnes isolated from synovial tissue and fluid in a patient with oligoarthritis associated with acne and pustulosis

This report describes the case of a patient with a 14-month course of severe oligoarthritis associated with acne. Pure cultures of Propionibacterium acnes were isolated from synovial tissue and synovial fluid specimens collected from the same joint after a 4-month interval. After 2 months of treatment with roxithromycin 300 mg/day, rifampicin 1,200 mg/day, and a nonsteroidal antiinflammatory drug (NSAID), followed by 4 months of treatment with azithromycin 1 gm/week and an NSAID, the synovitis persisted. Cultures of skin lesions and synovial fluid at this time were negative. Although P acnes has previously been isolated from bone specimens obtained from patients with osteitis associated with acne, this is the first report of the isolation of this microorganism from the synovial tissue of a patient with arthritis associated with acne. Our findings raise the question of the role of P acnes in the pathogenesis of arthritis associated with acne.     

The efficacy of using enzymes in treating toxic-allergic reactions after cataract extraction with intraocular lens implantation

In experimental study of antiulcerative activity of dibunol on various models of gastric ulcers in rats the drug caused a marked antiulcerative effect in all of them, reduced the incidence of ulcer formation, and shortened the time of ulcer healing. In a model of "acetic" ulcer dibunol oil solution led to quick normalization of lipid peroxidation in the gastric mucosa, which was evidence of high antioxidant activity in cases of ulcer lesions.     

Corneal endothelium in patients with diabetes after extracapsular cataract extraction with intraocular lens implantation in the posterior chamber

We have examined endothelial cell density before and 3, 6, 12 months after extracapsular cataract extraction with intraocular lens implantation (posterior chamber) in diabetic patients and in non-diabetics. We have not found statistically significant differences between the mean loss of endothelial cells due to surgery in diabetic and non-diabetic patients.     

Contrast detection in noise: a new method for assessing the visual function in cataract

The detectability of a signal decreases in the presence of externally added visual noise. A linear relation exists between the energy of a signal at threshold and the spectral density of the added visual noise. This relation, represented by contrast detection in noise function, allows a given loss in contrast sensitivity (CS) to be attributed to an increase in the internal intrinsic noise and/or a decrease in the detection efficiency of the observer. Intrinsic noise gives a measure of the random background noise within the visual system, whereas detection efficiency is a measure of how effectively the observer utilizes the available stimulus information. Recent work shows that neural dysfunction produces a decrease in the detection efficiency, whereas optical deficits produce a change in the intrinsic noise only. We investigated whether the CS loss in cataract can be attributed to either a change in intrinsic noise, in detection efficiency, or both. Contrast detection in noise functions was measured for 10 uniocular cataract patients. Comparison between the two eyes showed no significant difference in detection efficiency, although the intrinsic noise increased significantly in the cataractous eye. The data suggest that detection efficiency may provide a measure of neural visual function behind a cataract and, conversely, that intrinsic noise provides a measure of the visual effect of the cataract itself. We discuss the implications of intrinsic noise as a measure of cataract for both clinical assessment and research.     

Disruption of the transmembrane pH gradient--a possible mechanism for the antibacterial action of azelaic acid in Propionibacterium acnes and Staphylococcus epidermidis

The effect of the topical acne treatment azelaic acid on the transmembrane proton gradient (delta pH) of Propionibacterium acnes and Staphylococcus epidermidis was studied in vitro at external pH values found on human skin (pH 4.0-6.0). Bacteria were grown in defined media using continuous culture and delta pH was estimated by measuring the accumulation of [14C] benzoic by the cells using flow dialysis. In both P. acnes and S. epidermidis the addition of 30 mM azelaic acid and the membrane active inhibitors nigericin (150 microM) and CCCP (150 microM) resulted in a rapid release of [14C] label into the dialysate indicating the dissipation of delta pH between external pH values of 4.0-6.0. The addition of 60 mM NaCl as an iso-osmotic control and 150 microM valinomycin did not induce the release of [14C] label. The addition of 30 mM azelaic acid reduced the delta pH of P. acnes by 44% at external pH 4.0 and 28% at external pH 6.0. In S. epidermidis 30 mM azelaic acid reduced delta pH by 88% at external pH 5.0 and 20% at external pH 6.0. Rapid loss of viability occurred in suspensions of P. acnes and S. epidermidis containing 30 mM azelaic acid at pH 4.0 with no viable cells recovered after 60 min incubation. At pH 6.0 little change in viable numbers of P. acnes and S. epidermidis were observed over a 2 h incubation period. The results indicate that the antibacterial activity of azelaic acid is associated with the perturbation of intracellular pH.     

Prospective randomized study of a new method of providing postoperative pain relief following femoropopliteal bypass

The extensive incision required for femoropopliteal bypass using saphenous vein causes significant postoperative pain, principally within the distribution of the cutaneous branches of the femoral nerve. This prospective randomized study investigated the efficacy of continuous postoperative femoral nerve block in reducing both pain (visual analogue pain score) and the requirement for opiate analgesia. Ten patients received a femoral nerve block by infusion of 0.5 per cent bupivacaine (5 ml/h for 48 h) via an epidural catheter together with a patient-controlled analgesia (PCA) device containing morphine; a further ten patients used a PCA device alone. The median postoperative intravenous morphine requirement was significantly reduced in patients with a nerve block at 24 h (4 versus 33 mg, P < 0.01) and at 48 h (5 versus 37 mg, P < 0.01) compared with controls. Postoperative pain was effectively abolished in the former group. The addition of a nerve block to PCA provides superior pain control after femoropopliteal bypass.     

熔融钒渣直接氧化提钒方法节能减排初步分析

为了分析熔融钒渣直接氧化提钒方法在节能减排方面的效果,计算对比了该方法与现行钒渣焙烧提钒工艺能耗,结果显示熔融钒渣直接氧化提钒方法比现行钒渣焙烧提钒工艺节能2.09×106kJ/t（钒渣）,相当于减排CO2 178.00kg/t（钒渣）。该方法可为钒渣提钒工业的节能减排作出巨大的贡献。