Recurrent sulphaemoglobinaemia treated with neomycin.
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Anti-Bacterial Agents↗
Biomedical subjects
A Kruger
Publications and source records attributed to A Kruger.
Intravitreal injection of tissue plasminogen activator and gas in subretinal hemorrhage caused by age-related macular degeneration.
PURPOSE: To assess the efficacy and safety of intravitreal injection of recombinant tissue plasminogen activator and sulfur hexafluoride gas for displacement of subretinal hemorrhages in patients with age-related macular degeneration. METHODS: The authors injected 25 microg of recombinant tissue plasminogen activator and 0.5 mL sulfur hexafluoride gas intravitreally in 11 patients with subretinal hemorrhages of less than 3 weeks duration. Anatomic and functional results were evaluated. RESULTS: Displacement of subretinal blood was successful within the first week after surgery in 10 of 11 patients. This was accompanied by visual improvement in eight patients. After 1 year, visual acuity was better than before surgery in five patients. Diagnosis of a choroidal neovascularization by fluorescein angiography was possible in all patients, and was treated with laser photocoagulation in five. The authors observed no adverse effects of treatment. CONCLUSION: Recombinant tissue plasminogen activator and gas effectively displace subretinal blood in patients with age-related macular degeneration. Randomized studies are necessary to prove the benefit of this simple and safe method in patients with subretinal hemorrhage due to age-related macular degeneration.
Aged↗
New approaches in the management of choroidal neovascular membrane in age-related macular degeneration.
Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly population. The prevalence is reported to be 1.2-1.4% in several population-based epidemiological studies. Currently 25-30 million people worldwide are blind due to AMD. With the aging world population it is bound to increase significantly, and could become a significant public health problem in next two decades, with serious socio-economic implications. Several strategies are today available to treat the wet form of AMD, which is responsible for significant visual loss. These were until recently confined to laser photocoagulation, and subretinal surgery, but today two other modalities, namely, radiation and photodynamic therapy, are available. These treatment modalities however, are aimed at preservation of vision only, and not at reversing the process of the disease. Further research on antiangiogenic drugs and gene therapy could significantly help AMD patients.
Blindness↗
Course of postoperative inflammation after implantation of 4 types of foldable intraocular lenses.
PURPOSE: To compare the course of postoperative inflammation after small incision cataract surgery with implantation of 4 types of foldable intraocular lenses (IOLs). SETTING: Department of Ophthalmology, University Hospital of Vienna, Austria. METHODS: One hundred twenty eyes were prospectively randomized to receive a foldable silicone (Pharmacia 920), hydrogel (Bausch & Lomb Hydroview), methyl methacrylate/hydroxyethyl methacrylate (Mentor MemoryLens), or acrylic (Alcon AcrySof) IOL. All surgery was performed by the same experienced surgeon using a standardized surgical protocol: clear corneal incision, capsulorhexis, phacoemulsification, and in-the-bag implantation of the IOL. All patients received standardized postoperative medication and follow-up. Postoperative inflammation was evaluated by measuring aqueous flare preoperatively and 1, 3, 7, 14, 28, 90, and 180 days after surgery using the Kowa 1000 laser flare-cell meter. RESULTS: Except on the first day after surgery, when the AcrySof group had higher flare values than the other groups (P = .0265), no significant differences were found up to 6 months. Re-establishment of the blood-aqueous barrier was similar in eyes with the AcrySof, Hydroview, and MemoryLens IOLs; the course of postoperative inflammation was different in eyes with the silicone IOL. CONCLUSION: Comparison of postoperative flare values after implantation of 4 foldable IOLs showed no clinically relevant differences in the course of postoperative inflammation.
Acrylic Resins↗
Effect of cooled intraocular irrigating solution on the blood-aqueous barrier after cataract surgery.
PURPOSE: To evaluate the effect of cooled intraocular irrigating solution during phacoemulsification on postoperative blood-aqueous barrier (BAB) disturbance. SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: In a prospective, randomized clinical study, 40 eyes with senile cataract had phacoemulsification with irrigating solutions cooled to approximately 10 degrees C (n = 20) or at room temperature (n = 20). Surgical procedure and postoperative therapy were otherwise identical in both groups. Postoperative BAB disturbance was assessed with the laser flare-cell meter on days 1, 3, 7, 14, and 28. RESULTS: Anterior chamber flare was significantly lower in the group with cooled irrigating solution on postoperative day 1. There was no significant between-group difference in flare on any other postoperative day. CONCLUSION: Cooled intraocular irrigating solution reduced immediate postoperative inflammation compared with irrigating solution at room temperature. However, this effect was of short duration.
Aged↗
Tumor necrosis factor alpha promoter polymorphism at position -238 is associated with chronic active hepatitis C infection.
Tumor necrosis factor alpha (TNF-alpha) is involved in the pathogenesis of chronic hepatitis C virus infection. The gene for TNF-alpha is encoded in the major histocompatibility locus (MHC). Two polymorphisms at positions -308 and -238 in the TNF-alpha promoter region might influence TNF-alpha expression. These promoter polymorphisms have been linked previously to a number of infectious diseases. TNF-alpha promoter polymorphisms at positions -238 and -308 were studied by DNA sequencing and sequence-specific oligonucleotide hybridization in 82 individuals with chronic hepatitis C and 99 control subjects. Subjects had been HLA class I and class II typed in a previous study. The frequency of the TNF238.2 promoter allele was significantly higher in the hepatitis C group (18.7%) compared to the controls (3.5%; P < 0.0001; pcorr < 0.009). No significant differences in the frequency of the TNF308.2 allele were observed between patients and controls. The increased frequency of the TNF238.2 allele could not be explained by linkage disequilibrium to HLA-B or -DR genes. These findings show an association between the TNF238.2 promoter variant and chronic active hepatitis C. They suggest that this polymorphism or a linked gene may be a host factor contributing to the development of chronic active hepatitis C.
Alleles↗
Topical fundus pulsation measurements in age-related macular degeneration.
BACKGROUND: The purpose of the present study was to investigate regional fundus pulsations in age-related macular degeneration (AMD) patients with subretinal neovascular membranes. METHODS: Local fundus pulsation amplitudes (FPAs) were measured in 12 patients with AMD with classic neovascular membranes. Measurements were performed directly on the membrane and adjacent to the membrane. FPAs were assessed with a recently developed laser interferometric method. FPA measurements were performed in 12 healthy subjects at similar posterior pole locations. RESULTS: In AMD patients FPAs were consistently lower when measured directly on the neovascular membrane ("inside") than at measurement sites around the membrane ("outside"). The difference in FPA was 26 +/- 3% (mean +/- SEM, range 13-40%, P < 0.0001). In healthy subjects, however, FPAs were significantly higher at the measurement points corresponding to "inside" points (15 +/- 4%, P < 0.0006). CONCLUSIONS: We have shown that FPAs are reduced at classic neovascular membranes in patients with AMD. The mechanism behind this finding remains unclear. Hence, future studies have to ascertain whether this observation is associated with changes in fundus layers or with local choroidal perfusion abnormalities.
Aged↗
Postoperative inflammation after clear corneal and sclerocorneal incisions.
PURPOSE: To compare two standard small incision techniques for cataract surgery--clear corneal incision and sclerocorneal incision--with regard to postoperative disturbance of the blood-aqueous barrier (BAB). SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: This prospective comparative study comprised 108 eyes with senile cataract. A clear corneal tunnel incision was made in 53 eyes and a sclerocorneal incision with tunnel preparation in 55. All other surgical procedures and postoperative medication were standardized. Postoperative BAB disruption was measured with a laser flare-cell meter (Kowa FC 1000) in an undilated pupil on 1, 3, 7, 14, 28, 60, and 90 days postoperatively. The values were compared using a two-sided t-test. RESULTS: In both groups, flare and cell values were highest on the first postoperative day. They gradually declined but without recovery of preoperative flare values on day 28. At no time was there a noticeable between-group difference in mean cell and flare values except for flare at day 14 (P = .04). CONCLUSION: Postoperative trauma, measured by the BAB disturbance, was equally low after clear corneal and sclerocorneal incisions.
Aged↗
A tumor necrosis factor-alpha (TNF-alpha) promoter polymorphism is associated with chronic hepatitis B infection.
Cytokines such as TNF-alpha and interferon gamma (IFN-gamma) are important for the elimination of infected hepatocytes during acute hepatitis B virus (HBV) infection. Two G versus A transitions in the TNF-alpha promoter region at positions -308 and -238 possibly influence TNF-alpha expression. We investigated these TNF-alpha polymorphisms in 71 patients with chronic HBV infection, in 32 subjects that had spontaneously recovered from acute HBV infection, and in 99 healthy controls. The -238 A promoter variant was present in 18 (25%) of 71 patients with chronic HBV infection compared with two (6%) of 32 subjects with acute infection (P<0.04), and seven (7%) of 99 controls (P<0.003). By contrast, the prevalence of the variant at position -308 was similar in all investigated groups. The observed differences could not be explained by linkage disequilibrium to HLA-B or -DRB1* alleles. These findings suggest an association between the TNF-alpha promoter polymorphism at position -238 and the development of chronic HBV infection. This promoter variant appears to be linked to defective viral clearance.
Alleles↗
Mapping the human retina.
The new therapeutic method of scotoma-based photocoagulation (SBP) developed at the Vienna Eye Clinic for diagnosis and treatment of age-related macular degeneration requires retinal maps from scanning laser ophthalmoscope images. This paper describes in detail all necessary image analysis steps for map generation. A prototype software system for fully automatic map generation has been implemented and tested on a representative dataset selected from a clinical study with 50 patients. The map required for the SBP treatment can be reliably extracted in all cases. Thus, algorithms presented in this paper should be directly applicable in daily clinical routine without major modifications.
Algorithms↗
Short-term oral pentoxifylline use increases choroidal blood flow in patients with age-related macular degeneration.
OBJECTIVE: To study the ocular hemodynamic effects of a 3-month oral treatment with pentoxifylline in patients with nonexudative age-related macular degeneration. DESIGN: Double-blind, placebo-controlled, randomized, parallel group study. SETTING: Outpatient clinic of the Department of Ophthalmology, Vienna University, Vienna, Austria, that specializes in age-related macular degeneration. METHODS: Forty patients with age-related macular degeneration received pentoxifylline (400 mg 3 times a day orally, n=20) or placebo (n=20) for 3 months. Retinal blood flow was assessed by scanning laser Doppler flowmetry and pulsatile choroidal blood flow was assessed by laser interferometric measurement of fundus pulsation amplitude. MAIN OUTCOME MEASURES: Changes in retinal blood flow and fundus pulsation amplitude. RESULTS: Four patients receiving pentoxifylline and 3 patients receiving placebo discontinued medication because of nausea. In the remaining subjects, the use of pentoxifylline increased ocular fundus pulsation amplitude (P<.001 vs placebo and baseline). The maximum increase was 28% after 3 months. In contrast, retinal blood flow was not changed by the use of pentoxifylline. CONCLUSIONS: A 3-month course of oral pentoxifylline treatment increases choroidal but not retinal blood flow in patients with age-related macular degeneration. These data strongly support the concept that pentoxifylline might be useful in the treatment of age-related macular degeneration. Long-term clinical outcome trials are now warranted to test this hypothesis.
Administration, Oral↗
Intraoperative and postoperative complications of high-frequency capsulotomy and continuous curvilinear capsulorhexis.
PURPOSE: To compare the intraoperative complications and postoperative blood-aqueous barrier (BAB) disturbance after high-frequency capsulotomy and continuous curvilinear capsulorhexis (CCC). SETTING: Vienna General Hospital, Vienna, Austria. METHODS: This prospective, randomized clinical study evaluated 53 eyes with senile cataract. Patients were divided into two groups: high-frequency capsulotomy (n = 27) or CCC (n = 26). The surgical procedure and postoperative therapy were standardized for both groups. The intraoperative course was documented, and postoperative complications were examined by biomicroscopy 3 months postoperatively. Without the pupil dilated, BAB disturbance was evaluated with a laser flare-cell meter at 1, 3, 7, and 14 days postoperatively. The findings were analyzed statistically. RESULTS: Intraoperatively, the high-frequency capsulotomy group had a significantly higher rate of radial tears in the anterior lens capsule. Postoperatively, this resulted in a higher incidence of postoperative false positioning of the intraocular lens. At no time were the flare-cell meter results between groups statistically significant. CONCLUSION: High-frequency capsulotomy resulted in no more trauma than CCC. It can be a good alternative to conventional techniques, particularly in eyes with no red reflex. However, the technique is associated with less mechanical stability.
Aged↗
A TNF-alpha promoter polymorphism is associated with juvenile onset psoriasis and psoriatic arthritis.
Tumor necrosis factor-alpha is considered to be one of the important mediators in the pathogenesis of psoriasis. A strong association of juvenile onset psoriasis with the major histocompatibility complex encoded HLA-Cw6 antigen has been reported but it is unclear whether Cw6 itself or a closely linked gene is involved in the pathogenesis. This study has focused on the association of promoter polymorphisms of the major histocompatibility complex encoded tumor necrosis factor-alpha gene with psoriasis and psoriatic arthritis. Tumor necrosis factor-alpha promoter polymorphisms were sought by sequence-specific oligonucleotide hybridization and by direct sequencing in Caucasian patients with juvenile onset psoriasis and with psoriatic arthritis and in healthy controls. A mutation at position -238 of the tumor necrosis factor-alpha promoter was present in 23 of 60 patients (38%; p < 0.0001; p[corr] < 0.008) with juvenile onset psoriasis and in 20 of 62 patients (32%; p < 0.0003; p[corr] < 0.03) with psoriatic arthritis, compared with seven of 99 (7%) Caucasian controls. There was a marked increase of homozygotes for this mutation in the psoriasis group. Another mutation at position -308 was found in similar proportions of patients and controls. Our study shows a strong association of the tumor necrosis factor-alpha promoter polymorphism at position -238 with psoriasis and psoriatic arthritis. Our findings suggest that this promoter polymorphism itself or a gene in linkage disequilibrium with tumor necrosis factor-alpha predispose to the development of psoriasis.
Adult↗
In Electra's voice: Gilligan's debt to Freud.
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Female↗
Chronic psychiatric patients' use of caffeine: pharmacological effects and mechanisms.
The uses and effects of caffeine as a psychoactive drug in chronic psychiatric inpatient groups are described. Caffeine use and abuse is linked etiologically to diverse psychiatric disorders; its mechanisms of action are examined in relation to anxiety, anxiety neuroses, psychosis, schizophrenia, and caffeine intoxication and dependence. It is postulated that deleterious effects may result from the interaction of caffeine with commonly prescribed psychotropic drugs. A possible model of caffeine abuse is discussed. Increased public education about potential health problems related to caffeine consumption is suggested, and further controls of caffeine in psychiatric settings are recommended.
Arousal↗
The goldfish as a model for studying neuroestrogen synthesis, localization, and action in the brain and visual system.
Organizational and activational effects of estrogen (E) in the central nervous system (CNS) are exerted directly by circulating E and indirectly after aromatization of circulating androgen to E in the brain itself. Understanding an environmental chemical's ability to disrupt E-dependent neural processes, therefore, requires attention to both pathways. Because aromatase (Aro) is highly expressed in teleost brain, when compared to mammals and other vertebrates, fish are technically advantageous for localization and regulation studies and may also provide a model in which the functional consequences of brain-derived (neuro-)E synthesis are exaggerated. Recently, Aro was immunolocalized in cell bodies and fiber projections of second- and third-order neurons of the goldfish retina and in central visual processing areas. Authentic Aro enzyme activity was verified biochemically, suggesting a heretofore unrecognized role of sex steroids in the visual system. Initial studies show that in vivo treatment with aromatizable androgen or E increases calmodulin synthesis and calmodulin protein in retina and also affects retinal protein and DNA. Whether there are related changes in the processing of visual information that is essential for seasonal reproduction or in the generative and regenerative capacity of the goldfish visual system requires further investigation.
Animals↗
The midlife transition: crisis or chimera.
The construct of the midlife crisis is examined on definitional, developmental, psychoanalytic, and existential dimensions, and the literature reviewed. The DSM-III-R criteria for Adjustment Disorder appear to subsume the midlife crisis paradigm, and only a small percentage of people high in neuroticism are prone to developmental crises. It is argued that the crisis model is a contemporary social construct that has outlived its usefulness.
Adjustment Disorders↗
Both fish oil and olive oil lowered plasma fibrinogen in women with high baseline fibrinogen levels.
This double-blind, cross-over study with olive oil as placebo, examined the effect of a daily dosage of 6 g fish oil on cardiovascular risk markers of 20 healthy young volunteers (10 men, 10 women). Serum lipids and lipoproteins, and plasma coagulation and fibrinolytic enzymes, including fibrinogen concentrations and plasminogen activator inhibitor-1 (PAI-1) activity were measured at baseline and after 6-week supplementation of either fish or olive oil. The results showed that fish oil had an independent lowering effect on triglycerides and coagulation factors Vc and VIIc. Both fish and olive oil significantly raised PAI-1 levels and lowered plasma factor Xc and fibrinogen levels in the women, who had higher initial levels than the men. Mean fibrinogen levels of the women were lowered from 3.23 +/- 0.98 to 2.64 +/- 0.55 g/l and from 3.19 +/- 0.72 to 2.66 +/- 0.49 g/l by fish and olive oil respectively. This study raises the question whether a particular fatty acid or group of fatty acids, or another constituent of the oil such as vitamin E may be responsible for the fibrinogen lowering effect.
Administration, Oral↗