Combination of phacoemulsification and implantation of soft intraocular lens: a most important new trend in surgery for cataract (first clinical experience)

Sixty-seven patients with cataracts of different degree of maturity were operated on using phacoemulsification with implantation of soft IOLs through a dot self-hermetized incision. The advantages of this method over interventions with a large incision are a shorter postoperative rehabilitation (2-3 weeks), no postoperative astigmatism, low traumatism, and a lower risk of pre- and postoperative complications. Insertion of soft IOLs with injectors permits intraocular correction of vision through a dot incision used in phacoemulsification; no sutures are needed, and hospital stay is decreased to just 1-2 days.     

The polarized light microscopic appearance of caries-like lesions adjacent to restored cavities in the crowns and roots of extracted human teeth

Longitudinal clinical studies indicate consistently that secondary caries is the major cause of failure of restorations. Recently there has been an increase in the number of fluoride-containing materials coming to the market place and this has renewed the debate about the cariostatic effectiveness of such materials. The present study examined the histologic appearance of caries-like lesions adjacent to a non-fluoride-containing material (amalgam), a low fluoride-containing material (composite) and a moderate fluoride-containing material (glass-ionomer). The artificial caries system used to produce lesions has been previously reported and is a microbial system using Streptococcus mutans NCTC 10832. The lesions produced were similar to naturally occurring lesions in many respects, indicating the usefulness of this in vitro technique. Variations in the appearance of lesions were found adjacent to the different materials and the effect of the fluoride contained within two of the materials is discussed.     

Procedure guideline for myocardial perfusion imaging. Society of Nuclear Medicine

BACKGROUND AND PURPOSE: Parenterally administered MgSO4 is neuroprotective in standard animal models of focal cerebral ischemia and in many other paradigms of brain injury. Previous small clinical trials in stroke patients have explored the safety and tolerability of different infusion regimens. This study was undertaken to optimize the regimen for a multicenter trial. METHODS: Within 24 hours of the onset of clinically diagnosed stroke, patients were randomized to receive placebo or one of three intravenous MgSO4 infusions: a loading infusion of 8, 12, or 16 mmol, followed by 65 mmol over 24 hours. Cardiovascular parameters, serum magnesium concentrations, and blood glucose concentrations were determined. Outcome at 30 and 90 days was recorded. RESULTS: Twenty-five patients were recruited and treated at a mean time of 20 hours after stroke. No tolerability problems were identified. No effects of magnesium on heart rate, blood pressure, or blood glucose were evident. Serum magnesium concentrations rose to target levels most rapidly in the highest loading infusion group and were maintained in all groups for at least 24 hours. CONCLUSIONS: MgSO4 infusions that rapidly elevate the serum magnesium concentration to potentially therapeutic levels are well tolerated and have no major hemodynamic effects in patients with acute stroke. The 16-mmol loading infusion achieved target serum concentrations most rapidly and has been chosen for further trials.     

Propofol and thiopental in a 1:1 volume mixture is chemically stable

Propofol and thiopental have been used clinically in combination for induction of anesthesia. Studies suggest that this mixture has synergistic activity, recovery characteristics similar to propofol alone, and bactericidal effects on multiple organisms. It may therefore be both clinically useful and cost-effective. In this study, we examined the chemical stability of this mixture. We used high-performance liquid chromatography to quantify the concentration of both propofol and thiopental in a given sample. This technique allows the detection of loss in total drug mass and of the appearance of breakdown products resulting from drug interaction. Ten samples of a 1:1 mixture by volume were prepared and assayed at Time 0 and Days 1, 3, and 7. Half the samples were incubated at 23 degrees C and the rest were stored at 4 degrees C. Other mixtures were assayed before and after filtration at Time 0 and Days 1 and 7 after storage at 23 degrees C. The assay was able to measure accurately the quantity of drug present in the samples. There was no significant decrease in the quantities of either propofol or thiopental in the mixture over the 7-day period. We conclude that the 1:1 volume mixture of propofol and thiopental is chemically stable for 1 wk at room temperature. Implications: A mixture of propofol and thiopental has been used to induce anesthesia. We investigated the chemical stability of this mixture using high-performance liquid chromatography and found it to be stable for at least 24 h.     

Immunoreactivity of normal rabbit serum with epinephrine (E) cells of the rat adrenal medulla after microwave antigen retrieval

Normal rabbit serum (NRS) produces intense staining of epinephrine (E) cells in microwave-heated sections of rat and mouse adrenal gland. This staining is not eliminated by liver adsorption, complement inactivation, high salt buffer, Triton X-100 or dilution in normal goat serum and bovine serum albumin (BSA), suggesting that it may result from specific antigen-antibody interactions. Western blots of adrenal medullary protein probed with NRS reveal several bands. The major band does not correspond to rat chromogranin A, which is a major constituent of E-cell secretory granules. The findings suggest that NRS may contain autoantibodies against a secreted rabbit E-cell protein with a homologous counterpart in rats and mice, and that this protein may be immunologically unmasked in situ by microwave heating. This phenomenon is a potential source of error in immunohistochemical studies of the adrenal medulla, and has potential biological significance in neuroimmunology.     

Strand asymmetry of CpG transitions as indicator of G1 phase-dependent origin of multiple tumorigenic p53 mutations in stem cells

In dividing cells, expression of mutations is DNA strand symmetric. Of all mutations originating de novo in nondividing cells, only those in the transcribed (noncoding) strand are immediately expressed in mRNA and protein. In contrast, any new mutation in the nontranscribed (coding) strand remains unexpressed until the cells enter S phase and begin proliferation. This previously unrecognized difference enables us to examine the cell cycle-dependent origin of multiple tumorigenic mutations in stem cells. The human p53 gene, which acts as a gatekeeper in the control of G1 to S phase transition, was chosen for the analysis. Of all multiple mutations contained in p53 databases, we have tested in detail CpG transitions. Three features of CpG sites dictate this choice: C --> T transitions at methylated mCpG are the direct product of mC deamination and are replication-independent; it is easy to identify the strand bearing a primary mC --> T event because C --> T on the transcribed strand appears as G --> A on the nontranscribed strand; and CpG transitions are the most frequent (as both singular and multiple occurrences) tumor-related p53 mutations. The origin of double nonsilent CpG transitions in nondividing cells predicts a significant excess of the heterostrand (C --> T, G --> A) doublets over the homostrand (C --> T, C --> T and G --> A, G --> A) doublets. For p53, we found such an excess. Based on this result, along with the results of three other tests reported here, we conclude that the majority of multiple p53 mutations from human tumors occurred in quiescent stem cells.     

Investigations of nuclear magnetism in silver down to picokelvin temperatures. I

Nuclear magnetic ordering in silver has been investigated by the low-field NMR technique using an rf SQUID. Spin entropies down to 0.50 · R ln 2, corresponding to polarizations up to 78%, were obtained. An indication of antiferromagnetic ordering was observed in the static magnetic susceptibility, which showed clear saturation at the beginning of warmup after cooling to T<1 nK by adiabatic demagnetization to B=10±5 µT; the critical entropy of the transition was found to be S_c=(0.60±0.04) · R ln 2. The NMR absorption increased in the ordered state at frequencies around 75 Hz. Remnants of this increase were observed in the paramagnetic phase as well. The feasibility of experiments at negative spin temperatures was demonstrated by a quick reversal of the external magnetic field.On leave of absence from the Institute for Solid State Physics, University of Tokyo.     

Diagnostic and prognostic significance of biochemical indicators in colorectal neoplasms

Activities of some enzymes and content of medium-weight molecules in patients with colorectal cancer were studied in order to assess the diagnostic value of these parameters for detection of tumors in the large intestine and development of endogenous intoxication after surgery and for prediction of remote results of treatment. Increased activities of creatine phosphokinase and hexokinase is typical of tumor growth, whereas increased activities of alkaline phosphatase and gamma-glutamyl transpeptidase are observed only in metastases to the liver. The role of medium-weight molecules in the diagnosis of endogenous intoxication during the early postoperative period is shown. The content of these molecules in the sera increases 3 days before clinical manifestation of endotoxicosis, when the traditional parameters are virtually normal.     

Comparative immune response from vaccinating chickens with lentogenic Newcastle disease virus strains

The immune response of chickens to 11 isolates of LaSota strain Newcastle disease virus (NDV) and to 7 isolates of B1 strain NDV was studied in specific-pathogen-free chickens. Most of the vaccine strains were from commercial vaccine producers. Comparison of immunogenicity were made of these vaccines; five other lentogenic NDV strains, not used commercially, were also evaluated. From the criteria of hemagglutination inhibition (HI) and virus serum (VN) neutralizing titers, differences were observed with certain isolates within the LaSota and B1 vaccine groups. Whereas the majority of vaccine strains fell within a predictable range, some proved considerably less in their ability to engender expected titers. Two-to threefold differences in titers were observed with some of the strains compared. Two cloned LaSota NDV strains did not compare favorably, or with expected higher titers, with uncloned or conventional LaSota strain virus isolates. Similarly, certain B1 and LaSota strains passaged in chickens did not demonstrate a greater immunogenic potential over conventional, commercial vaccines of similar strain designation but not passaged in chickens. Whereas none of the NDV strains demonstrated evidence of neurotropism or lethality, postvaccination respiratory reactions were difficult, if not impossible, to evaluate in laboratory isolation units. The complexity of selecting ND vaccines for field use is discussed briefly.