Effect of photodynamic therapy with verteporfin on tumor thickness and best corrected visual acuity in patients with circumscribed choroidal hemangioma: a single-center experience.

The management of circumscribed choroidal hemangioma (CCH) with photodynamic therapy (PDT) using verteporfin has resulted in significant functional and clinical improvement compared with the pre-PDT era. Literature data on factors influencing clinical outcomes and predictors of response to PDT in symptomatic CCH are inconsistent. The aim of this study was to investigate the efficacy of PDT with verteporfin in patients with CCH depending on symptom duration and tumor thickness at baseline. We analyzed the medical records of 37 patients with symptomatic CCH divided into 3 groups according to symptom duration (≤ 50 weeks, 51 - 100 weeks, and > 100 weeks) and into 2 groups according to tumor thickness (≤ 2.3 mm and > 2.3 mm). Patients were subjected to PDT with verteporfin at a concentration of 6 mg/m2 body surface area and a light dose of 50 J/cm2 at a wavelength of 689 nm. The mean number of treatment sessions was 1.57 (range, 1 - 3). Tumor thickness, the transverse and longitudinal diameters of the tumor base, and best corrected visual acuity (BCVA) were evaluated at baseline and at 12 - 15 months after treatment. After PDT, the mean tumor thickness in the whole study group decreased by 1.19 ± 0.66 mm (from 3.14 mm to 1.95 mm). Subgroup analyses revealed no significant differences between the 2 groups divided according to tumor thickness (p = 0.49). However, tumor thickness differed significantly between the 3 groups divided according to symptom duration (p < 0.05). BCVA increased in 22 patients (59.5%), remained unchanged in 12 patients (16.2%), and decreased in 3 patients (10.1%). Our study provides evidence for the efficacy of PDT with verteporfin in terms of improving or stabilizing visual function as well as reducing tumor thickness in patients with CCH, including those with long-lasting disease.

Differences in anti-endothelial and anti-retinal antibody titers: implications for the pathohysiology of acute and chronic central serous chorioretinopathy.

The aim of the study was to evaluate the prevalence of serum anti-retinal (ARAs) and anti-endothelial cell antibodies (ACEAs) in patients with acute and chronic central serous chorioretinopathy (CSC). We enrolled 28 patients with acute CSC, 42 patients with chronic CSC, and 40 healthy controls. The presence of ARAs was determined by indirect immunofluorescence using monkey retina as an antigen substrate, while the presence of AECAs was determined using cultivated human umbilical vein endothelial cells (HUVECs) and primate skeletal muscle according to the manufacturer's instructions (Euroimmun AG). There were no differences in the prevalence of antibodies against rods, cones, cytoplasmic components of retinal nuclear layer cells, and retinal vessels between the acute and chronic CSC groups and the control group (P = 0.27, P = 0.16, P = 0.71, and P = 0.06, respectively). However, AECAs reactive with HUVECs were observed in 46% of patients with acute CSC, 45% of those with chronic CSC, and 22% of controls, whereas AECAs reactive with the skeletal muscle were present in 46%, 45%, and 15%, respectively (difference between groups: P = 0.045 for HUVECs and P = 0.005 for the skeletal muscle). Furthermore, AECA titers were higher in CSC patients than in controls (P = 0.004). This study provides evidence for the possible involvement of an autoimmune process directed against vessel antigens in the pathogenesis of CSC. AECAs may be more important than ARAs in this disease and may be involved in endothelial damage in the choroidal vessels and choriocapillaris, leading to hyperpermeability, which is central to the pathophysiology of CSC.

Mydrane intracameral injection site can be an alternative to mydriatic drops instillation in cataract surgery.

The aim of this study is to compare Mydrane (combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%) and mydriatic drops (tropicamide 1% and phenylephrine 10%) used for cataract surgery in terms of efficacy in pupil dilation and impact on corneal endothelial cell density (CD) and central corneal thickness (CCT). Prospective study including 64 eyes of 64 patients that underwent phacoemulsification with intraocular lens implantation. Patients were randomized into two groups: Mydrane group received: tropicamide and phenylephrine one day preoperatively and Mydrane during the surgery. Reference group received: tropicamide and phenylephrine preoperatively. Pupil size was measured only in Mydrane group, in the same eye of the same patient one day preoperatively after mydriatic drops were given and during the surgery, after intracameral Mydrane injection. CD and CCT were evaluated one day preoperatively and one month postoperatively in all patients and compared between Mydrane and reference groups. The results show CCT and CD significantly decreased after surgery in both groups. There is no difference in this decrease between groups. In Mydrane group there was no difference in dilated pupil diameter between Mydrane and mydriatic drops. Gender, diabetes mellitus, POAG, alpha-1 blocker treatment failed to affect pupil dilation obtained with Mydrane. Cataract surgery affects CCT and CD regardless of which mydriatic protocol had been used. Pupil diameter was similar after drops instillation and after Mydrane injection in all patients from the Mydrane group.

New RIA kit for the determination of progesterone in cows' milk.

A new, single-step, specific, simple, economical, and ready to use RIA test for the determination of progesterone in cow's milk was developed. Tubes coated with the specific polyclonal anti-progesterone antibody and progesterone-CMO-125I-histamine as the tracer were used. Progesterone in buffer and fat-free cow's milk, without progesterone were the matrix for the standard curve preparation. Fifty microL of milk and 500 microL of tracer were incubated in the tube for 2 h at room temperature, decanted, and coated. Assay range was 0-270 nmol of progesterone x 1(-1); sensitivity, <1 nmol x 1(-1); recovery, 94-104%; precision as CV%, 2.44-6%.

[Pregnancy in patients with end-stage renal failure on maintenance dialysis: case reports]. / Ciaza u pacjentek przewlekle dializowanych z powodu terminalnej niewydolnosci nerek--opisy przypadków.

Pregnancy in women with end-stage renal failure on maintenance dialysis is rare, and the chance of successful delivery is relatively low. In this paper we present two cases of women who conceived just prior to initiation of renal replacement therapy and the pregnancy was terminated successfully already on chronic dialysis treatment. The special attention was paid on the necessity of multi-disciplinary collaboration and the need for changes in regular dialysis schedule as the conditions crucial for successful delivery. In summary, the review of current literature dealing with mentioned problem was done.

[The study of seasonal variability in the rehabilitation of bronchial asthma]. / Badanie zmiennosci okolorocznej skutecznosci rehabilitacji w astmie oskrzelowej.

The aim of the study was to ascertain whether the seasons of the year influence the course of mild or moderate bronchial asthma, and to assess the effectiveness of respiratory kinesitherapy. In outpatients one month cycles of respiratory kinesitherapy were performed (twice a week for 45 min.) and were still repeated three times in the next seasons of the year. Spirometric and psychological examinations and also the self-evaluation of dyspnea were performed before and after each cycle. Additionally PEF was self-measured by the patients every day. It has been shown that seasons of the year influence neither the values of spirometric parameters of lung ventilation, the circadian rhythm of PEF, nor the effectiveness of respiratory kinesitherapy. However, the repeated cycles of effective breathing favourably influenced the psychic condition and reduced the subjective feeling of dyspnea, as well as improved the quality of asthmatics' life.

[Chronobiology in medical practice]. / Chronobiologia w praktyce lekarskiej.

This review is intended to present some practical applications of the knowledge of biorhythms for both diagnostic and therapeutic purposes.

[Purulent mediastinitis]. / Ropne zapalenie sródpiersia.

The aspects of acute purulent mediastinitis (APM) have been reported on the basis of the analysis of 14 cases treated in the last 5 years. The most frequent causes of APM were the complications after surgery on esophagus ad trachea (10 cases). The other group included patients operated on by sternotomy. Three patients survived. In both of them diagnosis was established within 12 hours from the beginning of APM and early re-thoracotomy was performed. The rest of the patients died because of sepsis and multiply organ failure (MOF). The conclusion is that only early diagnosis as well as aggressive surgical treatment give a chance to save life in such a dangerous severe complication.

[Mediastinal emphysema]. / Odma sródpiersia.

18 patients have been treated in our department for mediastinal emphysema (ME) during last 15 years. Small degree ME was found in 5 cases medium degree ME in 6 cases and in 5 patients tension emphysema was noted. Small degree ME was caused by abdominal and thyroid gland surgery, middle degree ME was recognized after surgical treatment of the mediastinal tumors or after mediastinal traumas. Tension emphysema of the mediastinum was observed in patients artificially ventilated, after blunt chest injuries or in the course of pneumonia. Sometimes it was impossible to establish the cause of ME. Tension emphysema of the mediastinum was usually life-threatening and required decompression.

Multivariate analysis of the impacts of the turbine fuel JP-4 in a microcosm toxicity test with implications for the evaluation of ecosystem dynamics and risk assessment.

Turbine fuels are often the only aviation fuel available in most of the world. Turbine fuels consist of numerous constituents with varying water solubilities, volatilities and toxicities. This study investigates the toxicity of the water soluble fraction (WSF) of JP-4 using the Standard Aquatic Microcosm (SAM). Multivariate analysis of the complex data, including the relatively new method of nonmetric clustering, was used and compared to more traditional analyses. Particular emphasis is placed on ecosystem dynamics in multivariate space.The WSF is prepared by vigorously mixing the fuel and the SAM microcosm media in a separatory funnel. The water phase, which contains the water-soluble fraction of JP-4 is then collected. The SAM experiment was conducted using concentrations of 0.0, 1.5 and 15% WSF. The WSF is added on day 7 of the experiments by removing 450 ml from each microcosm including the controls, then adding the appropriate amount of toxicant solution and finally bringing the final volume to 3 L with microcosm media. Analysis of the WSF was performed by purge and trap gas chromatography. The organic constituents of the WSF were not recoverable from the water column within several days of the addition of the toxicant. However, the impact of the WSF on the microcosm was apparent. In the highest initial concentration treatment group an algal bloom ensued, generated by the apparent toxicity of the WSF of JP-4 to the daphnids. As the daphnid populations recovered the algal populations decreased to control values. Multivariate methods clearly demonstrated this initial impact along with an additional oscillation seperating the four treatment groups in the latter segment of the experiment. Apparent recovery may be an artifact of the projections used to describe the multivariate data. The variables that were most important in distinguishing the four groups shifted during the course of the 63 day experiment. Even this simple microcosm exhibited a variety of dynamics, with implications for biomonitoring schemes and ecological risk assessments.

Morning vs evening effects of intrapulmonary administration of heparin in healthy men.

Calcium heparin in a dose of 13,200-15,300 U was administered in 8 healthy men, aged 26-54, by inhalation at 8:00 or 20:00, where each study was separated by a minimum of three weeks interval. Serum coagulation variables, lipids, electrolytes and enzymes were measured before inhalation, 2 h later and after 48 h. Following heparin inhalation changes both in coagulation variables and less distinct in lipids variables were noted at both test times, but no morning-evening differences were observed, with the exception of cholesterol and HDL.

[Duodenal pressure ulcer as a cause of anemia]. / Odlezyna dwunastnicy przyczyna niedokrwistosci.

A case is presented of anaemia which was caused by decubitus ulcer and fistula of the duodenum developed as a result of pressure exerted by aortofemoral vascular prosthesis.

Vitamin B12 absorption in some selected pathological states of the gastrointestinal tract.

The absorption of vitamin B12 in selected pathological states of the gastrointestinal tract was studied. Schilling test was performed with 37 kBq (1 microCi) of 57Co-labelled vitamin B12 as an analysis of urinary radioactivity. No increase in cobalamin absorption was present after exogenous IF had been administrated to patients after resection of the upper part the stomach and total gastrectomy. This suggests that there is another factor likely to affect vitamin B12 absorption.

[Characteristics of the main risk factors of coronary disease among the population of Warsaw and rural agricultural population of the Tarnobrzeg province]. / Charakterystyka glównych czynników ryzyka choroby niedokrwiennej serca w populacji wielkomiejskiej Warszawy i rolniczo-przemyslowej województwa tarnobrzeskiego.

Basing on results of first screening of the Pol-MONICA Project in 1984 in two centres that is the Tarnobrzeg province and two districts of Polish capital Warsaw (Praga South and Praga North) the level of 11 main coronary disease risk factors was compared in 2469 men and 2729 women. The following 5 risk factors were statistically significant for both men and women: the Durnin index of body fat content, the total cholesterol concentration in the plasma, triglyceride level, numbers of daily meals. The mean level of two factors that is the HDL-cholesterol concentration and the HDL-cholesterol/total cholesterol ratio was lower in the Warsaw sample what speaks in favor of concept that the ischemic heart disease threat is greater in that population. Among men the Warsaw population exhibited moreover the significantly higher value of diastolic blood pressure as well as of Quetelet body mass index; age and numbers of cigarettes smoked daily has also been higher in that population. In women from the Tarnobrzeg province ++ the diastolic blood pressure was higher than that in the Warsaw population. The two populations studied showed also highly significant differences so far as the complex of all 11 features is concerned what enabled the qualification of 72.3% of men, and 68.4% of women as belonging to the big city population or to the agricultural-industrial population using the discriminant Fisher function.