VARIATION OF 24-HOUR INTRAOCULAR PRESSURE IN SILICONE OIL-FILLED EYES.

PURPOSE: To evaluate the variation of 24-hour intraocular pressure (IOP) in silicone oil (SO)-filled eyes. METHODS: Prospective, nonrandomized comparative case series of 42 eyes of 21 patients, each with an SO-filled eye after vitrectomy. The fellow eyes served as controls. Each subject slept the usual 8 hours, and IOPs were measured at 4-hour intervals over 24 hours, twice before sleep (5:30 and 9:30 PM), twice during sleep (1:30 and 5:30 AM), and twice after sleep (9.30 AM and 1:30 PM). Intraocular pressure was measured in the sitting position using a Goldmann applanation tonometer. The SO-filled eyes and fellow eyes were compared with respect to diurnal-to-nocturnal and nocturnal-to-diurnal IOP changes. RESULTS: At all 6 time points, SO-filled eyes had higher mean IOPs than fellow eyes (all P < 0.05). For both groups, mean nocturnal IOP was higher than mean diurnal IOP (both P < 0.001). Changes in diurnal-to-nocturnal IOP and nocturnal-to-diurnal IOP between SO-filled eyes and fellow eyes did not differ significantly (P > 0.05, respectively). The peak IOP occurred in the nocturnal period for all fellow eyes and for 94.7% of SO-filled eyes. CONCLUSION: The IOP of SO-filled eyes varied over a 24-hour period, peaking largely in the nocturnal period, as observed for the IOP of fellow eyes.

Two cases of CHARGE syndrome with multiple congenital anomalies.

We report on two cases of bilateral chorioretinal colobomas with ocular anomalies in patients with CHARGE syndrome. In the first case, a female infant was born at 36 + 5 weeks gestation. At birth, the patient demonstrated a small left eye. Slit-lamp examination revealed colobomas of both irises. Fundus examination showed both chorioretinal colobomas. Brain magnetic resonance imaging (MRI) showed left microphthalmia. Systemic evaluation revealed multiple congenital anomalies: benign external hydrocephalus, esophageal atresia with imperforate anus, atrial septal defect (ASD), ventricular septal defect, patent ductus arteriosis (PDA), and right mild hydronephrosis. In the second case, a male infant was born at 39 + 5 weeks gestation and demonstrated a dysmorphic appearance with an irregular left pupil and ptosis. Fundus examination of both eyes showed large chorioretinal colobomas involving the optic disc and posterior pole. The patient had multi-organ anomalies: right facial palsy, a left short, wide ear with a small lobe, congenital heart defects, such as ASD and PDA, left renal atresia, seizure disorder, and micropenis. Both cases revealed multiple anomalies including nearly all major and minor criteria of CHARGE syndrome which could be life-threatening to neonates. Thus, all neonates with ocular colobomas should have fully and detailed systemic examinations checking all minor criteria and even occasional findings of CHARGE syndrome.

Clinical and urodynamic effect of methylphenidate for the treatment of giggle incontinence (enuresis risoria).

AIMS: We retrospectively investigated the efficacy of methylphenidate (MPH) in giggle incontinence (GI), and the relationship between GI and urodynamic parameters. METHODS: Nine (n = 9) female GI patients underwent 1 year of treatment with 5 mg MPH. Three questionnaires, voiding diaries, and UDS were conducted before and after treatment. The severity of GI was classified into mild, moderate, and severe. Clinical success was characterized as: full response, response, partial response, and non-response. RESULTS: The mean age of all patients was 16.2 ± 2.3 years. Five patients had mild, one had moderate, and three had severe grade incontinent. All patients reported complete cessation of wetting after MPH treatment. The mean duration of asymptomatic period was 7 ± 3.2 months. There were no statistically significant score changes in all three questionnaires: Urgency Perception Scale (UPS), Overactive Bladder Symptom Score (OABSS) and Primary Overactive Symptom Questionnaire (POSQ), and voiding diaries (P > 0.05). In UDS, there were no statistically significant altered parameters, except maximum urethral closure pressure (MUCP) and maximum urethral pressure (MUP). After treatment, the mean MUCP was increased from 52.2 ± 6.8 to 73.0 ± 5.4 cmH(2) O (P < 0.05), and the mean MUP was increased from 48.6 ± 7.3 to 70.2 ± 5.0 cmH(2) O (P < 0.05). CONCLUSIONS: MPH can be a viable option for the primary treatment of GI, and it may be related to increasing urethral closure pressure. It was not possible to establish if a relationship between GI and detrusor overactivity exists.

Hydrodynamic relationship between color Doppler ultrasonography findings and the number of internal spermatic veins in varicoceles.

PURPOSE: The improvement of testicular volume, testosterone levels and sperm concentration was suggested to be significantly associated with the number of internal spermatic veins (ISVs) ligated during varicocelectomy. Herein, we investigated preoperative color Doppler ultrasonography (CDU) findings as potential preoperative predictors of the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy. MATERIALS AND METHODS: In a prospective evaluation of 40 patients, maximal vein size and maximal reflux velocity were measured, while the total cross-sectional area of the affected testicular veins during a Valsalva maneuver was calculated using CDU by a single uroradiologist. Microsurgical subinguinal varicocelectomies were performed by one urologist. RESULTS: Among the semen parameters, semen morphology showed significant improvement (p=0.033), which was much clearer in the patients with a higher number of ISVs ligated than a lower number of ISVs ligated. Among the various preoperative variables, maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated (r=-0.442, p=0.004; r=0.594, p=0.000, respectively). Furthermore, univariate and multivariate linear regression analyses showed that maximal reflux velocity and total cross-sectional area on CDU were independent predictive factors of the number of ISVs ligated. CONCLUSION: Maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated. This means that the maximal reflux velocity and total cross-sectional area measured by preoperative CDU can predict the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy, which might be related to significant improvement of semen parameters after varicocelectomy.

The establishment of dendritic cell-tumor fusion vaccines for hormone refractory prostate cancer cell.

PURPOSE: Dendritic cell (DC)-based tumor vaccine is an attractive modality for the treatment of hormone-refractory prostate cancer (HRPC) because it has some efficacy and few side effects in patients with poor general conditions. The aim of this study was to establish which is the most effective DC vaccine for the treatment of HRPC. We compared DC vaccine sensitized with tumor lysate and a fusion vaccine of DCs and tumor cells. MATERIALS AND METHODS: The DU145 cancer cell line was purchased from the American Type Culture Collection. DCs were cultured from peripheral blood monocytes. Peripheral blood monocytes were cultured in RPMI 1640 medium supplemented with interleukin-4 (IL-4), granulocyte-macrophage colony-stimulating factor, and 10% fetal calf serum. Tumor necrosis factor-alpha was added on day 7 to support maturation. Functional activity was measured in three groups: the DC single-culture group, the DC culture group with DC vaccine sensitized with tumor lysates, and the DC culture group prepared with tumor fusion vaccine made from irradiated tumor cells and monocyte-derived DCs by the polyethylene glycol method. RESULTS: By FACS analysis, the rate of DC-tumor fusion vaccine was 20.3+/-3%. The IL-12 level produced by the DC-tumor fusion vaccine was significantly higher than that of DCs pulsed with tumor lysate (p<0.05). Also, the generation of interferon-gamma by tumor-specific T cells in the DC-tumor fusion vaccine group was superior to that of DCs pulsed with tumor lysate (p<0.05). In addition, the T cells of the tumor lysate-pulsed DCs and tumor fusion vaccine had 1.6 and 2.5 times the functional activity, respectively, of the DC single-culture group in killing tumor cells in the cytotoxicity assay. CONCLUSIONS: The DC-tumor fusion vaccine seems to be more effective than DC single-culture or DC-tumor lysate vaccine in the treatment of HRPC.

Vardenafil Enhances Oxytocin Expression in the Paraventricular Nucleus without Sexual Stimulation.

PURPOSE: Oxytocin is associated with the ability to form normal social attachments. c-Fos is an immediate early gene whose expression is used as a marker for stimulus-induced changes in neurons. The effect of phosphodiesterase-5 (PDE-5) inhibitors on oxytocin activation in the brain without sexual stimuli has not yet been reported. In the present study, we investigated the effects of vardenafil on oxytocin and c-Fos expression in the paraventricular nucleus (PVN) of conscious rats. METHODS: Male Sprague-Dawley rats weighing 300±10 g were divided into 6 groups (n=5 in each group): the control group, the 1-day-0.5 mg/kg, the 1-day-1 mg/kg, the 1-day-2 mg/kg, the 3-day-1 mg/kg, and the 7-day-1 mg/kg vardenafil administration group. The experiment was conducted without sexual stimulation. Vardenafil was orally administered. The animals in the control group received an equivalent amount of distilled water orally. The expression of oxytocin and c-Fos in the PVN was detected by immunohistochemistry. RESULTS: Oxytocin expression in the PVN was increased by 1 day administration of 2 mg/kg vardenafil, and this effect of vardenafil appeared in a duration-dependent manner. c-Fos in the oxytocin neurons of the PVN was increased by 1 day administration of 2 mg/kg vardenafil, and this effect of vardenafil also appeared in a duration-dependent manner. These results showed that vardenafil augments the expression of oxytocin with activation of oxytocin neurons in the PVN. CONCLUSIONS: In this study, we showed that the PDE-5 inhibitor, vardenafil directly enhances oxytocin expression and also activates oxytocin neurons in the PVN, which indicates that vardenafil may exert positive effects on affiliation behavior and social interaction.