The effect of topical corticosteroids on refractive outcome and corneal haze after photorefractive keratectomy

BACKGROUND: The effect of topical corticosteroids after excimer laser photorefractive keratectomy (PRK) remains a matter of some controversy. Refractive effects may be different according to the amount of myopia and timing of instillation. METHODS: Two groups of patients were studied: Study A consisted of 215 eyes (128 patients) with PRK (mean baseline myopia, -6.53 +/- 2.22 D) that received no corticosteroids (No Corticosteroid Group) unless significant regression or corneal haze appeared (Delayed Corticosteroid Group), and in Study B, we randomly assigned eyes to the Initial Corticosteroid Group (mean baseline myopia, -6.39 +/- 1.84 D) or the No/delayed Corticosteroid Group (mean baseline myopia -5.78 +/- 2.02 D). Clinical results after PRK for low-to-moderate and high myopia were compared. RESULTS: In the first group, 70.9% (73 eyes) of moderately myopic eyes (mean, -4.56 +/- 1.10 D) belonged to the No Corticosteroid Group that had a mean refraction of -5.39 +/- 1.77 D. Delayed Corticosteroid Group eyes were more myopic (mean, -7.52 +/- 2.10 D), and showed more severe haze than those in the No Corticosteroid Group. In study B, only in high myopes with more than -6.00 D (mean, -7.76 +/- 1.15 D) did refraction and corneal haze outcomes show significant difference between the Initial Corticosteroid Group and the No/delayed Corticosteroid Group. CONCLUSIONS: The effects of topical corticosteroids after PRK were less in moderate myopes compared to high myopes. Delayed instillation of corticosteroids did not reverse the regression or haze whereas initial instillation showed a beneficial effect on high myopes but not on moderate myopes.     

Functional role of high-affinity anandamide transport, as revealed by selective inhibition

Anandamide, an endogenous ligand for central cannabinoid receptors, is released from neurons on depolarization and rapidly inactivated. Anandamide inactivation is not completely understood, but it may occur by transport into cells or by enzymatic hydrolysis. The compound N-(4-hydroxyphenyl)arachidonylamide (AM404) was shown to inhibit high-affinity anandamide accumulation in rat neurons and astrocytes in vitro, an indication that this accumulation resulted from carrier-mediated transport. Although AM404 did not activate cannabinoid receptors or inhibit anandamide hydrolysis, it enhanced receptor-mediated anandamide responses in vitro and in vivo. The data indicate that carrier-mediated transport may be essential for termination of the biological effects of anandamide, and may represent a potential drug target.     

Longitudinal weight changes, length of survival, and energy requirements of long-term care residents with dementia

OBJECTIVE: We hypothesized that institutionalized patients with dementia, who frequently have feeding problems and require supervised and assisted feeding, would lose more weight during their residency than nondemented, independently functioning residents and have compromised survival. To test this hypothesis, we examined the survival and longitudinal changes in weight of two cohorts of institutionalized residents with dementia and compared these cohorts with a cohort of nondemented residents. We also measured the resting energy expenditures of a subset of the subjects with dementia as an indicator of their energy needs. DESIGN: A longitudinal cohort study with retrospective baseline chart review and subsequent follow-up of monthly weights and mortality over 4 years. SETTING: A 725-bed long-term care institution with specified levels of care. SUBJECTS: Two cohorts of residents with dementia, one consisting of subjects who required total care throughout their institutional stay (n = 31) and another group who did not initially require total care (n = 48); these were compared with a cohort with normal mentation who were functionally independent in their daily activities (n = 26). The total number of subjects was 105. MEASUREMENTS: Demographics, medical problems, and medications by chart review; functional and mental status evaluations; longitudinal monthly weights and mortality for the 48-month study period; and resting energy expenditures by indirect calorimetry. MAIN RESULTS: Residents with dementia had lower weights on admission and throughout their stay than nondemented, independently functioning residents, and they were more likely to have a weight loss of 10 lbs or more at some point during the 4-year study period. However, their mean weights did not change during the study period. The mean survival from admission of those demented residents who died was more than 3 years. Resting energy expenditures of women residents with advanced dementia were 12% lower than predicted from the Harris Benedict equations. CONCLUSION: Dementia is not necessarily associated with unremitting weight loss during institutionalization despite the frequent occurrence of feeding difficulties and temporary weight loss. This may be caused partly by the lower than expected resting energy expenditures and, hence, energy needs of affected residents as their dementia progresses. Demented residents weighed significantly less than nondemented, independently functioning residents throughout their institutional stay. Nevertheless, nursing staff are able to maintain weight and survival for extended periods even in very impaired residents.     

Conversion of acrylonitrile-based precursors to carbon fibres

The progress of stabilization of two compositions of acrylic fibres with various orientations has been followed by a variety of techniques. The thermooxidative treatments for stabilization have been carried out in a continuous process and also in a batch process under free shrinkage, constant length and constant tension conditions. The morphological model of acrylic fibres consists of an alternating sequence of laterally ordered and laterally disordered regions along the fibre direction. This structure is consistent with the observations based on small-angle X-ray scattering of copper- impregnated precursor fibres and thermomechanical response, thermal stress development, calorimetry, wide- and small-angle X-ray scattering and sonic modu-lus measured at different extents of stabilization. Lateral as well as orientational order in these fibres can be increased markedly through a high-temperature deformation process prior to stabilization. An increase in perfection and extent of order is observed in the early stages of stabilization. There is also a simultaneous decrease in the orientation of the disordered phase at this stage and the extent of this decrease depends on the axial constraints imposed on the fibre. Little difference in the rate of stabilization is observed as measured by density or oxygen uptake for fibres with different extents of orientation, lateral order or restraint. Fibres containing itaconic add, a stabilization catalyst did show an increased rate of stabilization. Inferences have been drawn regarding additional research pertaining to achieving high order in precursor fibres, minimizing orientational relaxation during oxidative stabilization, and the techniques for monitoring the extents of the stabilization treatment and the changes in relevant morphological parameters.     

Optimized hydrogen positions for aluminium and iron containing hydroxide minerals

The structures of a number of hydroxide and oxyhydroxide minerals have previously been reported without the hydrogen positions explicitly defined. Here we use two atomic scale computer simulation techniques, one based on classical ionic potentials, the other on density functional theory (DFT), to predict these positions. The aim is not only to provide data that can be used as the basis for future experimental structure optimizations but also model parameters that can be used to predict complex hydroxide structures. The efficacy of the approach is demonstrated through the comparison of predicted and experimental data for minerals whose hydrogen positions are known.     

Spotlight mode SAR stereo technique for height computation

This paper examines the feasibility of extracting three-dimensional (3-D) or topographic information in spotlight mode stereo synthetic aperture radar (SAR). A display of a SAR (intensity) image has two axes: range and cross-range. Elevated scatterers appear closer in range; this phenomenon is called radar image layover. How the height of each scatterer can be computed from the difference in its layover between two images is investigated. This is analogous to computing height from disparity distance (triangulation) in optical stereo. The same procedure can be applied on pixel by pixel basis for terrain elevation mapping. A general expression is derived for the accuracy of the height estimate as a function of the range resolution and the angular difference between the image planes. Accuracy increases as the angle between the image planes increases, but the bright scatterers in one image tend to fade in the other image. This limited angular persistence of radar scatterers is also discussed. Trajectories for data collection are examined that provide near-optimal height estimates while eliminating the scatterer persistency problem.