To evaluate the correlation between improvement in visual acuity and the reduction of foveal thickness after a single intravitreal injection of 4 mg of triamcinolone in diabetic macular edema.
...Prospective, interventional, nonrandomized clinical trial.
patients In a prospective study 24 eyes with diabetic macular edema were treated with an intravitreal injection of 4 mg of triamcinolone acetonide. main outcome measures: Best-corrected logMAR visual acuity and optical coherence tomography were performed at baseline and 3 months after the treatment.
At baseline the average foveal thickness was 462 ± 154 μm (95% confidence interval, 397–527 μm) and at 3 months 257 ±114 μm (95% confidence interval, 209–305 μm) (P < .0001). The best-corrected logMAR average visual acuity was 60.5 ± 10.5 (95% confidence interval, 56.0–65.0) ETDRS letters at baseline compared with 65.5 ± 11.1 (95% confidence interval, 60.8–70.1) 3 months after the injection (P = .0001). There was no correlation between the improvement in visual acuity and the reduction of foveal thickness (r = 0.054, P = .8), but there was a correlation between reduction in foveal thickness and the age of the patients (r = 0.53, P = .008).
A single injection of 4 mg of intravitreal triamcinolone acetonide effectively reduces the foveal thickness in diabetic macular edema and improves visual acuity, but there does not appear to be a strong correlation between the reduction of foveal thickness and the improvement in visual acuity.
KOWEY, P.R., et al.: Clinical Outcome of Patients Who Develop PAF After CABG Surgery. This was a retrospective analysis of patients who had CABG surgery at our hospital over a 12‐month period to ...determine the intermediate‐term prognosis of those who had developed PAF after their operation before hospital discharge. Of 317 patients who were operated by a single surgical group, 116 (37%) had AF postoperatively of whom 112 had the paroxysmal form. Of these, 36 were treated with class I or III antiarrhythmic drugs and rate control drugs (group 1) and 76 were treated with rate control alone (group 2). Group 3 consisted of 151 randomly selected patients who did not have AF. All patients were reevaluated at 6 weeks to determine their rhythm and clinical status. Only one patient each in groups 1 and 2 was in AF 6 weeks after discharge. There was a trend toward a higher mortality and morbidity in group 2 patients. PAF after coronary surgery appears to be a self‐limited disease process. In this cohort of patients, the rate of recurrence of AF after discharge was similar in patients receiving class I or class III antiarrhythmic drugs together with rate control agents compared to those receiving rate control drugs alone.
Vasoproliferative retinal tumors Windisch-Furrer, R; Kurz-Levin, M M; Sutter, F K ...
Klinische Monatsblätter für Augenheilkunde
224, Številka:
4
Journal Article
Recenzirano
Vasoproliferative Tumors of the retina (VPTR) are benign tumors of unknown origin, occurring mostly in otherwise systemically healthy patients. These highly vascularised tumors are characterised by a ...pink to yellow colour on funduscopy and are usually situated in the inferior part of the retina. They are associated with intraretinal hemorrhages, intra- or subretinal exudates and hyperpigmentation of the retinal pigment epithelium.
We performed a retrospective case review of seven cases which have been diagnosed with VPTR between 2004 and 2006 in the Department of Ophthalmology, University Hospital Zurich.
The median follow up was 8 months (range: 1-24 months). We found a presumed underlying cause for the VPTR in 6 out of 7 patients. 3 patients showed a long standing retinal detachment; in the other 3 there was an untreated chronic uveitis. In one case the tumour was surgically excised and histology was performed.
VPTR of the ocular fundus are a distinct entity in the differential diagnosis of intraocular tumors. These benign lesions represent reactive gliovascular proliferations, with varying degrees of both gliosis and of vascular proliferation. VPTR can be idiopathic, or they develop after inflammatory, vascular, traumatic, dystrophic or degenerative ocular diseases, in particular, uveitis. The major differential diagnosis includes other vascular lesions or tumors of the ocular fundus like capillary retinal hemangiomas, Coat' Disease or malignancies. The natural course of VPTR appears to be variable. The therapy is based on tumor size, localisation and complications.
Durability analysis of solar mirrors is attracting attention from Concentrating Solar Power (CSP) developers because guaranties of a suitable optical behavior during the whole service life time are ...required. To give realistic life time estimations in affordable time, research institutes are investing a lot of effort in developing appropriate accelerated aging tests. In this paper, an extensive test campaign of accelerated aging tests has been performed with silvered-glass mirrors from several manufacturers. Three commercial outdoor-proven products, a not outdoor-proven mirror prototype and two mirrors which showed degradation after only three years of outdoor operation in Spain and Australia have been tested. The accelerated agingtests were conducted for an extended period of time in order to determine the testing time at which the two mirror materials that showed degradation outdoors start to fail under the accelerated conditions. The degradation of the outdoor exposed mirrors is analyzed microscopically and compared to the degradation appearing under accelerated aging. The presented data on accelerated testing represents useful information for standardization of durability testing of solar mirrors.
Many epidemiological studies indicate a positive correlation between cataract surgery and the subsequent progression of age-related macular degeneration (AMD). Such a correlation would have ...far-reaching consequences. However, in epidemiological studies it is difficult to determine the significance of a single risk factor, such as cataract surgery.
We performed a retrospective case-control study of patients with new onset exudative age-related macular degeneration to determine if cataract surgery was a predisposing factor. A total of 1496 eyes were included in the study: 984 cases with new onset of exudative AMD and 512 control eyes with early signs of age-related maculopathy. Lens status (phakic or pseudophakic) was determined for each eye.
There was no significant difference in lens status between study and control group (227/984 23.1 % vs. 112/512 21.8 % pseudophakic, p = 0.6487; OR = 1.071; 95 % CI = 0.8284-1.384). In cases with bilateral pseudophakia (n = 64) no statistically significant difference of the interval between cataract surgery in either eye and the onset of exudative AMD in the study eye was found (225.9 +/- 170.4 vs. 209.9 +/- 158.2 weeks, p = 0.27).
Our results provide evidence that cataract surgery is not a major risk factor for the development of exudative AMD.
Nutrient intake, digestibility and live-weight changes were compared for groups of grazing cattle on two Swiss Alpine pastures in different regions (R1 and R2; both >1500 m above sea level) during 2 ...years (1997 and 1998). The R1 site was an improved pasture, while R2 was an unimproved pasture of poor nutritional quality. Replicated over 2 years, R1 groups comprised four Scottish Highland suckler cows together with their calves and four Brown Swiss dairy cows (17·8 kg/day milk) kept at high stocking rates (approx. 7 cows/ha) in short rotations (intensive management system). R2 groups comprised four Highland cows with calves managed at low density (approx. 0·4 cows/ha) and set-stocked (extensive management system). Grazing seasons lasted 77 days at R1 and 127 days at R2. Intake, digestibility and faecal excretion were estimated by the slow-release alkane indicator method. Average dry matter intakes in kg/day and g/kg W0·75/day (in parentheses) were 17·4 (151) for dairy cows at R1 and, significantly lower, 12·7 (133) and 11·1 (111) for beef cows at R1 and R2, respectively. Herbage dry-matter intake of calves was 1·2 kg/day at both locations. Calf weight gains measured over 77 days (0·69 kg/day) were similar at the two sites and thereafter declined only slightly at R2. The N content of the herbage selected was similar in the two regions, but in other respects the herbage at R2 was of significantly poorer nutritive quality as indicated by the lower digestibility of organic matter and neutral detergent fibre at R2 compared with R1. Through feed selection, nutrient intake by beef cows was sufficient to gain weight. In contrast, dairy cows at R1 lost on average more than 50 kg of weight. Calculations were made and discussed regarding N utilization and urinary N loss, and measured faecal N and mineral excretion to allow a quantitative assessment of nutrient returns to the sward. We conclude that Highland beef cattle make poorer use of improved Alpine pasture than dairy cows though they utilize pastures of poor nutritive quality under extensive management without loss of productivity.
The effect of a prolonged low dose infusion of bacterial lipopolysaccharide (LPs) on acute phase-like reactions was examined in heifers. LPS (2 μg kg
−1 dissolved in 100 ml water), or saline was ...infused (at 1 ml min
−1) intravenously for 100 minutes and blood samples were taken at various times before, during and after the infusion. The serum concentrations of tumour necrosis factor-alpha(
TNFα), interleukin-Ibeta (IL-1β), interleukin-6 (IL-6) and serum amyloid A (
SAA) and the rectal temperature increased in response to the
LPS infusion. Serum
TNFα increased before the increases in IL-1β and IL-6 and remained high from 20 minutes after the onset of the infusion until the end of the sampling period (six hours). The LPS-induced increases in serum IL-1β and IL-6 were biphasic. Plasma cortisol and lactate concentrations also increased, and plasma glucose and B-hydroxybutyrate concentrations decreased in response to the LPS infusion. The similarity of these reactions to changes observed in response to bacterial infections shows that the prolonged infusion of low doses of LPS is a good model for studying the acute phase response to Gramnegative bacterial infection in heifers.
Potassium-argon dating of five basalts from the three main islands of the Juan Fernández (or Robinson Crusoe) Islands of Chile in the southeastern Pacific gives ages of 1.01 $\pm $ 0.12 and 2.44 $\pm ...$ 0.14 million years for Masafuera 3.79 $\pm $ 0.20 and 4.23 $\pm $ 0.16 for Masatierra, and 5.8 $\pm $ 2.1 for Santa Clara. These ages are much younger than that of the underlying oceanic plate and are consistent with the origin of the island-seamount chain from a mantle hot spot beneath the eastward moving Nazca plate. The young age for the archipelago suggests that speciation within endemic genera has occurred within the past 4 to 5 million years. Endemic genera of apparently more ancient origins, such as Lactoris and Thyrsopteris, have apparently dispersed to the islands and survive refugially.
Summary
A 5‐week experiment with 24 multiparous early lactating Brown Swiss cows was conducted to investigate the effects of supplementary rumen‐protected methionine in conjunction with dietary ...protein reduction on metabolism and performance after 1 week of control measurement. Three rations containing 175, 150 and 125 g of crude protein/kg feed dry matter were supplemented with methionine. The fourth ration, also only containing 125 g of crude protein/kg dry matter, remained unsupplemented. The four treatment groups had a similar metabolic supply of other essential amino acids, protein and energy, as calculated by various approaches. The two low protein rations were, however, slightly deficient in ruminally degraded protein. Treatment effects remained low on feed intake, forage meal pattern, milk yield and fat as well as lactose content. In contrast, the content and yield of milk protein significantly declined only in the unsupplemented low protein ration relative to the initial value. Compared with this ration, the decline in milk protein yield was clearly delayed in the supplemented low protein ration. Blood plasma methionine tended to be reduced without supplementation and to be increased with additional methionine. Supplementation of methionine reduced other plasma amino acids. Plasma insulin, glucose, lactate, ketone bodies and aspartate amino transferase activity indicated a certain liver stress and a somewhat elevated energy requirement with high and particularly with low protein content (when unsupplemented). Methionine improved metabolic protein utilization, followed by the lowest plasma, urine and milk urea levels in the supplemented low protein diet. In conclusion, no major adverse effects were assessed under the conditions tested. Supplementation of methionine may nevertheless be useful in rations with particularly low protein content fed to early lactating cows in order to prevent negative long‐term effects which were only visible here as trends.
Zusammenfassung
Auswirkungen von pansengeschütztem Methionin in einer Niedrigproteinration im Vergleich zu Rationen mit erhöhtem Rohproteingehalt auf Stoffwechselmerkmale und Leistung von frischlaktierenden Milchkühen
In einem fünfwöchigen Experiment mit 24 frischlaktierenden Braunviehkühen wurden die Auswirkungen einer Ergänzung mit pansengeschütztem Methionin bei gleichzeitiger Reduktion der Proteinzufuhr nach einer einwöchigen Kontrollphase geprüft. Drei Rationen mit 175, 150 und 125 g Rohprotein/kg T wurden mit Methionin ergänzt. Eine weitere Variante, ebenfalls nur mit 125 g Rohprotein/kg T, wurde nicht supplementiert. Die vier Varianten stellten gemäß verschiedener Futterbewertungsysteme eine vergleichbare metabolische Versorgung mit den übrigen essentiellen Aminosäuren, Protein und Energie sicher. Die Niedrigproteinvarianten enthielten allerdings etwas zu wenig pansenabbaubares Protein. Futteraufnahme, Muster des Grundfutterverzehrs, Milchleistung sowie Fett‐und Laktosegehalt der Milch zeigten nur geringe Reaktion auf die Behandlungen. Milchproteingehalt und ‐menge waren nur in der nicht ergänzten Niedrigproteinvariante relativ zum Ausgangswert signifikant verringert. Im Vergleich zur unsupplementierten Niedrigproteinration war dagegen der Abfall mit Ergänzung deutlich verzögert. Gegenüber dem Ausgangswert war die Methioninkonzentration im Blutplasma ohne Ergänzung tendenziell erniedrigt, mit Ergänzung erhöht. Es erfolgte eine Verringerung der Plasmakonzentration anderer Aminosäuren durch die Methioninergänzung der Niedrigproteinration. Die Plasmaniveaus von Insulin, Glucose, Laktat, Ketonkörpern und Aspartataminotransferase‐Aktivität lassen auf eine gewisse Leberbelastung und einen etwas höheren Energiebedarf mit hohem und besonders mit niedrigem Proteingehalt (unsupplementiert) schließen. Die Zulage an Methionin verbesserte die metabolische Proteinverwertung, so dass die Harnstoffgehalte in Blut, Milch und Harn in dieser Niedrigproteinvariante am niedrigsten waren. Insgesamt ergaben sich keine grösseren ungünstigen Effekte unter den getesteten Bedingungen. Dennoch könnte die Ergänzung von Rationen mit besonders niedrigem Rohproteingehalt mit Methionin beim Einsatz an frischlaktierende Kühe hilfreich sein, um negative Langzeitwirkungen zu verhindern, die sich hier lediglich andeuteten.
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