Cataract surgery combined with transpupillary silicone oil removal through planned posterior capsulotomy

OBJECTIVE: The purpose of the study was to evaluate transpupillary removal of silicone oil combined with cataract surgery in patients after pars plana vitrectomy. DESIGN: A prospective case-control study. PARTICIPANTS: Fifty consecutive patients underwent cataract surgery combined with removal of silicone oil, which had served as intraocular tamponade after pars plana vitrectomy. In 28 patients, silicone oil was removed through a planned posterior capsulotomy, and in 22 patients, silicone oil was removed through pars plana sclerotomies. All patients were operated on by the same surgeon. INTERVENTIONS: Pars plana vitrectomy, cataract surgery, and silicone oil removal were performed. MAIN OUTCOME MEASURES: Frequencies of retinal redetachment, secondary cataract, cystoid macular edema, and vitreous hemorrhage; visual acuity; intraocular pressure; and duration of surgery and visual rehabilitation were measured. RESULTS: Frequencies of postoperative vitreous hemorrhage (1 of 28 [4%] vs. 10 of 22 [45%]) and secondary cataract (0 of 28 vs. 6 of 22 [27%]) were significantly lower (P < 0.05; chi-square test), and duration of surgery and visual rehabilitation were significantly shorter (P < 0.01) for patients with transpupillary silicone oil removal than for patients with drainage of silicone oil through pars plana sclerotomies. Rate of retinal redetachment (4 of 28 [14%] vs. 4 of 22 [18%]), time of retinal redetachment (36 +/- 32 postoperative days vs. 54 +/- 65 days), frequency of dislocated intraocular lenses (1 of 28 vs. 0 of 22), and postoperative visual acuity did not vary significantly between the two groups. Persisting comeal endothelial decompensation and clinically significant cystoid macular edema due to cataract surgery were not observed in any patient. CONCLUSIONS: Silicone oil removal can be combined with cataract surgery. In view of a decreased frequency of postoperative vitreous hemorrhage, reduced rate of secondary cataract, and shorter duration of surgery and visual rehabilitation, transpupillary drainage of silicone oil through a planned posterior capsulotomy compares favorably with removal of silicone oil through pars plana sclerotomies. Retinal redetachment usually occurs within the first 3 postoperative months.     

Chronic catheterization of the epidural space in rabbits: a model for behavioural and histopathological studies. Examination of meptazinol neurotoxicity

A technique of epidural catheterization in rabbits is described. Twelve albino rabbits received a totally implanted epidural catheter system. The system was implanted surgically, and the functioning of the system tested for a period of 3 months. X-ray examinations following epidural contrast injections showed a distribution up to Th4 following 1.5 ml and Th8-9 following 1.0 and 1.25 ml. Epidural injection of lidocaine throughout the study period proved the system to be functioning for all 3 months. Another 12 rabbits were included for the neurotoxicological examinations following epidural catheterization, without any injections (three rabbits), epidural injections of saline (four rabbits) and meptazinol (five rabbits) once a day for 14 days. Histopathological examinations showed a fibrous cocoon, at the tip of the catheter, in all rabbits. In the group of rabbits which did not receive any injections, the cocoon was slightly infiltrated with leukocytes and local depression of the spinal cord was observed in one rabbit. In the saline-injected group this infiltration was more pronounced and in one rabbit it extended into the meninges. Three rabbits showed local depression of the spinal cord and local myelopathy of the white matter in the area adjacent to the cocoon. In the group of rabbits receiving meptazinol, three out of five had local depression and myelopathy of the white matter. In this group these findings were more pronounced. In two rabbits the myelopathy extended transversely through the white matter into the grey matter of the spinal cord. The number of pathological changes in the group receiving meptazinol was significantly higher compared to the control and placebo groups.(ABSTRACT TRUNCATED AT 250 WORDS)     

Serum kynurenine-to-tryptophan ratio increases with progressive disease in HIV-infected patients

An alternative pathway of Trp metabolism involves the conversion of Trp to kynurenine by indoleamine-2,3-dioxygenase, which leads to synthesis of the neurotoxin, quinolinic acid. This study explores the relationship of indoleamine-2,3-dioxygenase activity with stages of HIV infection. Sera from 206 HIV-positive and 72 seronegative subjects were analyzed for Trp and kynurenine. The kynurenine-to-Trp (KT) ratio was calculated. The mean KT ratio of seronegative controls was 36.6 +/- 10.9, and the median ratio was 34.9. The upper limit of the seronegative KT ratio, defined as mean + 2 SD, was 58.4. Patients with HIV infection showed a reciprocal relationship between the KT ratio, the CD4 count, and the stage of the disease. The median KT ratios for asymptomatic and AIDS patients were 50.5 and 117.0, respectively. This study shows that the serum Trp concentration is markedly decreased and that the kynurenine concentration is increased with immune stimulation in HIV infection. This may lead to changes in quinolinic acid and explain some of the pathogenesis of AIDS dementia.     

Genetic heterogeneity in human T-cell leukemia/lymphoma virus type II

DNA from the peripheral blood mononuclear cells of 17 different individuals infected with human T-cell lymphoma/leukemia virus type II (HTLV-II) was successfully amplified by the polymerase chain reaction (PCR) with the primer pair SK110/SK111. This primer pair is conserved among the pol genes of all primate T-cell lymphoma viruses (PTLV) and flanks a 140-bp fragment of DNA which, when used in comparative analyses, reflects the relative degree of diversity among PTLV genomes. Cloning, sequencing, and phylogenetic comparisons of these amplified 140-bp pol fragments indicated that there are at least two distinct genetic substrains of HTLV-II in the Western Hemisphere. These data were confirmed for selected isolates by performing PCR, cloning, and sequencing with to 10 additional primer pair-probe sets specific for different regions throughout the PTLV genome. HTLV-II isolates from Seminole, Guaymi, and Tobas Indians belong in the new substrain of HTLV-II, while the prototype MoT isolate defines the original substrain. There was greater diversity among HTLV-II New World strains than among HTLV-I New World strains. In fact, the heterogeneity among HTLV-II strains from the Western Hemisphere was similar to that observed in HTLV-I and simian T-cell lymphoma/leukemia virus type I isolates from around the world, including Japan, Africa, and Papua New Guinea. Given these geographic and anthropological considerations and assuming similar mutation rates and selective forces among the PTLV, these data suggest either that HTLV-II has existed for a long time in the indigenous Amerindian population or that HTLV-II isolates introduced into the New World were more heterogeneous than the HTLV-I strains introduced into the New World.     

Childhood sexual trauma and substance misuse: a pilot study

This research investigates the type of and extent to which additional problematic experiences and behaviors are associated with a history of both substance misuse and childhood sexual abuse. In a recent study of women undergraduate students, 30 years and older, 15 disclosed a history of problematic alcohol and/or drug use. Of these, 10 had experienced sexual trauma as children; five had not. This report compares these two subsamples with respect to problematic experiences and behavior. Implications for counseling and research are discussed.     

High cytokine production and effective antitumor activity of a recombinant vaccinia virus encoding murine interleukin 12

We have constructed a recombinant vaccinia virus (recVV), vKT0334 mIL-12, containing the genes encoding the p35 and p40 subunits of murine interleukin-12 (mIL-12). In vitro experiments demonstrated that vKT0334 mIL-12 efficiently infected a variety of murine and human tumor cell lines and produced very high amounts (1.5 micrograms/10(6) cells/24 h) of biologically active mIL-12. Mice injected s.c. with 10(6) MCA 105 sarcoma cells, followed by injection at the same site with saline or a control recVV, vKT033, containing no mIL-12 genes, all developed progressively growing tumor, whereas 60% of animals injected with vKT0334 mIL-12 remained tumor free (P < 0.0005). Furthermore, tumor growth was significantly reduced in the remaining mice treated with vKT0334 mIL-12 that did develop tumor compared with mice treated with vKT033 (P < 0.03) or saline (P < 0.0001). We conclude that recVV expressing high levels of mIL-12 offers an effective in vivo method of cytokine gene delivery and expression in tumors with subsequent antitumor effect.     

Cephalometric evaluation of the changes in patients wearing complete dentures: a 20-year study

The purpose of this continuing longitudinal investigation was to study the changes on the craniofacial complex in complete denture wearers; herein are reported the 20-year findings. At the onset of the study complete dentures were made for 64 persons. Two dentures techniques were employed: a complex method of construction and a simplified method. At the start of the project the patients' ages ranged from 30 to 60 years (average age 53 years) and all had been edentulous for at least 1 year (range 1 to 30 years). Lateral cephalometric radiographs were made immediately after initial placement of the dentures and during subsequent years (1, 2, 3, 4, 5, 7, 10, 15, and 20). The same cephalostat was used throughout and all films were exposed with the teeth in centric occlusion. Thirty-four subjects presented for the 20-year follow-up. Of this number, the radiographs of 24 subjects (14 women and 10 men; average age 65.5 years [range 50-83 years]) (12 complex denture wearers; 12 simplified technique denture wearers) were used in this report (10 had denture alterations over the 20-year period that excluded them). The 20-year observations corroborate earlier findings. There is a loss of the vertical dimension of occlusion as viewed from the right profile, and the mandible rotates in a counterclockwise fashion resulting in an increase in relative prognathism. The maxillary alveolus was stable, the mandibular alveolus resorbed, and the dentures rotated counterclockwise and shifted slightly forward. The observed changes were not significantly affected by the sex of the patient or by the denture technique employed.