1,138 women with adnexal mass: pathologic findings according to age.

Purpose ofinvestigation: Influence of the patients' age are not well established to predict the malignancy potential of adnexal masses. This study was conducted to evaluate the impact of women's age on both histopathology and malignancy potential of adnexal masses. MATERIALS AND METHODS: This is a retrospective chart review study. Patients who were operated for suspected adnexal masses were included in the study. Malignancy potentials of tumors were divided in benign and at least borderline in univariate and multivariate analyses. Univariate analyses and RR calculations were performed according to malignancy potential for age, serum cancer antigen-125 (CA-125) levels and menopause status. RESULTS: A total of 1,138 women were included for this study; median age was 39 (16-92) years. Patients > 50 years had 5.920 times higher risk (95% CI 4.091-8.566; p = 0.0001) of having at least borderline tumor compared the younger group. The risk of at least borderline pathology was calculated as 3.723 (95% CI 2.595-5.342;p = 0.0001) in patients with CA 125 ≥ 35 IU/ml compared to the others. In multivariate analyses, only ≥ 35 IU/ml CA 125 level and > 50 years age groups were defined as independent variables for having at least borderline tumor. (OR: 4.456, 95% CI 2.982-6.659, p = 0.0001 and OR: 3.134, 95% CI 1.435-6.843, p = 0.004, respectively). CONCLUSION: In this study; the age of > 50 years was detected as an independent factor for having at least borderline pathology for adnexal masses. The data from these results might be used as a differential diagnostic tool in a new combination for benign and malignant adnexal masses in future studies.

Early metabolic defects in Arab subjects with strong family history of Type 2 diabetes.

AIMS AND OBJECTIVE: It is widely accepted that the genetic make-up of the subject plays a pivotal role in the development of insulin resistance and ß cell failure. The objective of this study was to examine whether the same or distinct genetic backgrounds contribute to the development of insulin resistance and ß cell failure. METHODS: We examined insulin sensitivity and ß cell function in lean normal glucose tolerance subjects from 3 multigeneration Arab families. Families 1 and 2 had strong history of Type 2 diabetes (T2DM), while no member of family 3 had T2DM. RESULTS: Subjects in family 1 manifested increased basal plasma free fatty acid (FFA) concentration and impaired suppression of plasma FFA during the OGTT compared to subjects in family 3. Subjects in family 2 had comparable fasting plasma FFA and suppression of plasma FFA during the OGTT to family 3. Both the absolute plasma glucose concentrations, and incremental area under the plasma glucose curve (ΔG0-120) during the OGTT were comparable in subjects of families 1 and 2, and were decreased in subjects of family 3. Whole body and muscle insulin sensitivity were comparable in subjects from families 2 and 3, and both were significantly decreased in subjects of family 1. Beta cell function was comparable in subjects of families 1 and 3 and was significantly decreased in subjects of family 2. CONCLUSION: These results demonstrate that distinct genetic background contributes to the development of insulin resistance and ß cell dysfunction in Arab individuals.

Relationship between heart rate variability and radial artery spasm in patients undergoing percutaneous coronary angiography via radial access.

OBJECTIVE: The objective of this study is to investigate the relationship and predictive power between heart rate variability (HRV) and radial artery spasm, in cases where the radial artery is preferred as the access route for coronary angiography (CAG). PATIENTS AND METHODS: A total of 394 patients, who were scheduled to have CAG were included in this study. Patients who developed radial artery spasms during CAG, performed using the radial artery as the access route, were analyzed for HRV parameters. RESULTS: Ages of the patients ranged between 31 and 74 years. Significant time domain measurements such as the standard deviation of normal-normal (NN) intervals, the standard deviation of the averages of NN, the average of the standard deviations of all NN intervals, and root mean square of successive differences between normal heartbeats were statistically significantly lower in the patient group that developed radial artery spasm. Frequency field measurements with prognostic values such as HF (high frequency) and very low frequency were also statistically significantly lower in the patient group that developed radial artery spasms. On the other hand, there was no statistical difference between the groups in LF (low frequency) and LF/HF ratio measurements. A statistically significantly higher radial artery spasm rate was observed in the coexistence of anxiety and low HRV. CONCLUSIONS: A significant decrease was found in major HRV values, which are closely related to the autonomic nervous system and its dysfunction, in patients with radial artery spasms.

Associating IDH and TERT Mutations in Glioma with Diffusion Anisotropy in Normal-Appearing White Matter.

BACKGROUND AND PURPOSE: IDH and TERT mutations might infiltratively manifest within normal-appearing white matter with specific phenotypes such as microstructural changes undetectable by standard MR imaging contrasts but potentially associable with DTI variables. The aim of this retrospective glioma study was to statistically investigate IDH and TERT associations and classifications with DTI reported microstructure in normal-appearing white matter. MATERIALS AND METHODS: Retrospective data from patients imaged between March 2012 and February 2016 were analyzed by grouping them as IDH-TERT subgroups and by IDH and TERT mutation status. DTI variables in the IDH-TERT subgroups were first identified by the Kruskal-Wallis test, followed by Dunn-Sidák multiple comparisons with Bonferroni correction. IDH and TERT mutations were compared with the Mann-Whitney U test. Classification by thresholding was tested using receiver operating characteristic analysis. RESULTS: Of 170 patients, 70 patients (mean age, 43.73 [SD, 15.32] years; 40 men) were included. Whole-brain normal-appearing white matter fractional anisotropy (FA) and relative anisotropy (RA) (P = .002) were significantly higher and the contralateral-ipsilateral hemispheric differences, ΔFA and ΔRA, (P < .001) were significantly lower in IDHonly patients compared with TERTonly, with a higher whole-brain normal-appearing white matter FA and RA (P = .01) and ΔFA and ΔRA (P = .002) compared to double positive patients. Whole-brain normal-appearing white matter ADC (P = .02), RD (P = .001), λ2 (P = .001), and λ3 (P = .001) were higher in IDH wild-type. Whole-brain normal-appearing white matter λ1 (AD) (P = .003), FA (P < .001), and RA (P = .003) were higher, but Δλ1 (P = .002), ΔFA, and ΔRA (P < .001) were lower in IDH mutant versus IDH wild-type. ΔFA (P = .01) and ΔRA (P = .02) were significantly higher in TERT mutant versus TERT wild-type. CONCLUSIONS: Axial and nonaxial diffusivities, anisotropy indices in the normal-appearing white matter and their interhemispheric differences demonstrated microstructural differences between IDH and TERT mutations, with the potential for classification methods.

High microsatellite and mitochondrial diversity in Anatolian native horse breeds shows Anatolia as a genetic conduit between Europe and Asia.

The horse has been a food source, but more importantly, it has been a means for transport. Its domestication was one of the crucial steps in the history of human civilization. Despite the archaeological and molecular studies carried out on the history of horse domestication, which would contribute to conservation of the breeds, the details of the domestication of horses still remain to be resolved. We employed 21 microsatellite loci and mitochondrial control region partial sequences to analyse genetic variability within and among four Anatolian native horse breeds, Ayvacik Pony, Malakan Horse, Hinis Horse and Canik Horse, as well as samples from indigenous horses of unknown breed ancestry. The aims of the study were twofold: first, to produce data from the prehistorically and historically important land bridge, Anatolia, in order to assess its role in horse domestication and second, to analyse the data from a conservation perspective to help the ministry improve conservation and management strategies regarding native horse breeds. Even though the microsatellite data revealed a high allelic diversity, 98% of the genetic variation partitioned within groups. Genetic structure did not correlate with a breed or geographic origin. High diversity was also detected in mtDNA control region sequence analysis. Frequencies of two haplogroups (HC and HF) revealed a cline between Asia and Europe, suggesting Anatolia as a probable connection route between the two continents. This first detailed genetic study on Anatolian horse breeds revealed high diversity among horse mtDNA haplogroups in Anatolia and suggested Anatolia's role as a conduit between the two continents. The study also provides an important basis for conservation practices in Turkey.

The predictive value of platelet/mean platelet volume ratio in predicting colon diverticulitis relapse.

OBJECTIVE: Diverticulitis is a health problem that has increased in frequency recently. It has a wide spectrum from simple inflammation to fecal peritonitis, sepsis and even mortality. Thus, it is important to predict diverticulitis, especially recurrent diverticulitis, and take measures to prevent it. In this study, we investigated the predictive value of the PLT/MPV ratio, which is an inflammation marker in predicting the recurrence of diverticulitis disease. PATIENTS AND METHODS: In this study, 132 patients diagnosed with diverticulitis were analyzed retrospectively. Patients' gender, age, localization of diverticulitis, number of diverticula in computed tomography (CT), hospitalization status, length of hospitalization, control colonoscopies, polyps' number and localizations in colonoscopies, presence of malignancy, need for surgery, and recurrences were not reported. White blood cell (WBC), Neutrophil (NE), Lymphocyte (LY), Hemoglobin (Hb), PLT, MPV, Albumin, Creatine Kinase (CK) and C-reactive protein (CRP) levels were examined. The patients were divided into two groups as those who did not relapse concerning diverticulitis and those who did, and statistical analysis was performed between the two groups about related parameters. RESULTS: Among all patients, recurrence was seen in 11 (10.1%) patients. The patients were divided into two groups according to their recurrence status and statistical significance was sought between the data. The calculated PLT/MPV ratio of patients who did not relapse was 25.61±8.05 and 34.98±11.37 for those who had a relapse (p=0.006). The sensitivity for MPV was 81.8%, a specificity of 57.1% and a cut-off of 9.85. The cut-off value for PLT was 207.5 with 100% sensitivity and 33.7% specificity. A cut-off value of 25.11 was found for PLT/MPV with 100% sensitivity and 49% specificity. CONCLUSIONS: PLT/MPV ratio was significantly higher in relapsed cases. Since it is easily accessible and inexpensive, it will guide physicians for diagnosis concerning early detection of relapse cases and initiation of appropriate treatment.

Dentists' knowledge about anaphylaxis caused by local anaesthetics.

BACKGROUND: IgE-mediated systemic reactions to local anaesthetics may be seen--although rarely--by dentists. However, it is not known whether dentists are familiar with symptoms, signs and management of anaphylaxis. METHODS: In this study we aimed to evaluate knowledge of dentists of the symptoms and signs and current treatment of anaphylaxis. For this, some dentists working in their private offices in Istanbul were asked to complete an anonymous questionnaire with 15 questions related to anaphylaxis. RESULTS: A total of 86 dentists agreed to participate in the study. None of the attendants were completely aware of the symptoms and signs of anaphylaxis. About half of the attendants (48.8%) knew epinephrine as the first drug in the treatment of anaphylaxis and keep it in their offices (55.6%), but only one third of the dentists (31.5%) preferred intramuscular route as the most effective route for epinephrine injection. CONCLUSION: Our data show that the level of dentists' knowledge of local anaesthetics allergy and anaphylaxis is inadequate. This may endanger patients' lives. An educational programme that may improve general dentists' knowledge about local anaesthetics allergy and anaphylaxis is urgently necessary.

Subjective sleep quality of cancer patients.

PURPOSE: to determine the quality of sleep, to locate the reasons for sleep disturbances and to define strategies overcoming sleep disturbances of cancer patients. METHODS: 175 cancer patients were included in this study. Data were collected using the Pittsburgh Sleep Quality Index (PSQI); a demographic data form and two open-ended questions on the reasons and coping strategies for sleep disturbances were filled in. RESULTS: the mean sleep quality score was 9.46 ± 4.669. The reasons given by patients for sleep disturbances were mostly cancer diagnosis (61.71%), adverse effects of therapy (58.85%), and financial problems (36.00%). Most patients (83.82%) used no pharmacologic strategies like lifestyle practices (64.25%), behavioral practices (21.25%), and biologic treatments (4.34%). Total PSQI scores of female patients were significantly higher compared to male patients, indicating poor sleep quality (Z=3.189; p=0.001). There was no statistically significant difference between age, education, illness duration, types of cancer and total PSQI scores (p>0.05). CONCLUSION: This research implied that cancer patients had poor sleep quality. Healthcare professionals should assess the sleep quality of cancer patients and solve this problem in a holistic perspective in order to provide a supportive environment during the caregiving process.

Quality of life and difficulties of patients encountered after autologous stem cell transplantation.

PURPOSE: To assess the quality of life (QoL) and difficulties of patients encountered after (at least day 100+) autologous stem cell transplantation (ASCT). METHODS: Patients from 4 bone marrow transplantation (BMT) centers in Ankara formed the study group. Data were collected via a socio-demographic form, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30), the Long-term BMT recovery questionnaire and a specific questionnaire adapted from Bush BMT Symptom Inventory for measuring symptom severity and symptom distress related to ASCT. Out of 114 eligible patients 67 (58.8%) responded the questionnaires and were included in the study. RESULTS: The mean time elapsed since transplantation was 16.1 months (range 4-43). Sixteen (23.9%) patients returned to work after transplantation; the mean time from transplantation to active work was 8 months. The symptoms experienced most, interfering with the patients' daily activities related to ASCT were fatigue, dental problems, hair loss, tingling sensation /numbness in hands and feet, mouth/throat problems, taste alterations, cough and skin problems. The majority of them reported fear of infection and disease relapse. Sexual dysfunctions, difficulty of concentration and difficulties of maintaining religious activities were also reported. 76% of patients reported their current QoL was the same or better than before transplantation and rated their current health-related QoL as good to excellent (mean 64.5). Financial difficulties, fatigue, sleeping problems, and pain were the factors most rated affecting QoL. CONCLUSION: Fear of disease relapse, economical problems and difficulties with physical activities were reported as the most difficult factors to deal with after transplantation, showing the importance of creating multidisciplinary teamwork for these groups of patients.

Effect of topical netilmicin on the reduction of bacterial flora on the human conjunctiva.

PURPOSE: To investigate the effects of topical netilmicin on human conjunctival bacterial flora. METHODS: Fifty-six patients' eyes with cataract were treated three times a day with netilmicin 1 day before the surgery. The fellow eyes of the patients were not treated. After 1 day of netilmicin application cultures of the inferior palpebral conjunctiva were performed in both eyes. Bacterial evaluation is qualitative. McNemar test was used for statistical analyses. RESULTS: The number of eyes with positive culture for coagulase negative staphylococcus (CNS) in untreated eyes was 43 (76.8%) and in treated eyes it was 5 (8.93%) and the difference was statistically significant (p=0.000). In untreated eyes number of negative cultures with no bacterial growth was 8 (14.3%) and it was 47 (83.9%) in the treated eyes. The difference among groups was statistically significant (p=0.000). Netilmicin is found very effective for CNS as the percentage of positive cultures (n=43) in untreated eyes to positive cultures (n=4) in the treated fellow eye was 90.7%. Likewise, all patients with Staphylococcus aureus positive cultures in untreated eyes (n=5) had negative culture for this microorganism in their treated fellow eyes (100%). CONCLUSIONS: The Endophthalmitis Vitrectomy Study demonstrated that the most common causes of postoperative endophthalmitis are coagulase negative microorganisms, S aureus and Streptococcus species. As netilmicin was found effective to reduce the number of positive cultures for these bacteria, it can be used to lower the incidence of postoperative endophthalmitis before surgery.

Long-term outcomes of heavy silicone oil tamponade for complicated retinal detachment.

PURPOSE: To assess the long-term success rates and complications of heavy silicone oil tamponade (Oxane HD) in the management of complicated retinal detachment with proliferative vitreoretinopathy (PVR). METHODS: Twenty-one eyes of 21 patients with complicated retinal detachment and PVR were included in this study. Vitreoretinal surgery with heavy silicone oil (Oxane HD) tamponade was performed in all patients. Heavy silicone oil was injected by perfluorocarbon liquid-air-silicone oil exchange, and was removed after 3 months. The main outcomes of the surgery including the success and complication rates were evaluated during the mean follow-up period of 11.4+/-0.88 months. Wilcoxon signed ranks test was used for statistical analysis of visual acuity changes. The outcomes of our study were compared with those of the previous studies. RESULTS: All eyes had complicated retinal detachment with PVR Grade C3 or worse. Retinal detachment was rhegmatogenous in 6 eyes, secondary to previous detachment surgery in 11 eyes, secondary to proliferative diabetic retinopathy in 3 eyes, and secondary to perforating eye injury in 1 eye. The overall anatomic success rate was 80.9% at the end of the follow-up period. The overall visual success rate was 42.8%, with no statistically significant difference from baseline (p>0.05). Postoperative complications included severe reproliferation (4 eyes), intraocular pressure rise (3 eyes), anterior dislocation of silicone oil (2 eyes), posterior subcapsular cataract formation (4 eyes), vitreous hemorrhage (1 eye), rubeosis iridis (3 eyes), optic atrophy (1 eye), and ocular pain and photophobia (21 eyes). CONCLUSIONS: According to the results of this study, vitreoretinal surgery with temporary heavy silicone oil tamponade appears to increase the anatomic success rates with minimal complication rate in cases with complicated retinal detachment and PVR.

Seeing the invisible: painless aortic dissection in the emergency setting.

Acute dissection of the aorta can be one of the most dramatic cardiovascular emergencies. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterised as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. In this report, the authors present two patients with painless aortic dissection who were misdiagnosed during their initial evaluation in the emergency department.

Plasma amino acid profile in autism spectrum disorder (ASD).

OBJECTIVE: In our study, we aimed to reveal pathophysiologic mechanisms in ASD by comparing plasma amino acid levels between patients and healthy controls while considering vitamin B12 and D levels. PATIENTS AND METHODS: The study included 21 patients aged 2-18 years-old who were followed with a diagnosis autism spectrum disorder (ASD) and 21 age and sex-matched healthy children from our outpatient clinic as control group. RESULTS: The study included 42 children and adolescents aged 2-18 years-old (19 girls and 23 boys). There were no significant differences in terms of body weight and height between the groups. We found significant differences in levels of ammonium, phosphoethanolamine, histidine, homocysteine, carnosine, methionine, cystathionine, cystine, threonine, 3-methyl histidine and phenylalanine/tyrosine ratio between patient and control groups. Both vitamin B12 and D were significantly lower in the ASD group compared to controls. In the variance analysis with vitamin B12 and D as covariates, significant differences persisted for only phosphoethanolamine (p=0.04), cystathionine (p<0.001), cystine (p=0.006) and threonine (p=0.02). CONCLUSIONS: Further studies are needed on the amino acids that show variations in children with ASD in order to reveal their role in the etiology and therapeutic use in ASD.

Value of QT dispersion in diagnosis of restenosis after intracoronary stent implantation.

We studied the ECGs of patients with single vessel disease before and after (long term) coronary stent implantation. The interlead variability of the QT interval, known as QT dispersion (QTd), is believed to reflect the regional variations in ventricular repolarization and, thus, may provide an indirect marker of arrhythmogenicity. There are no reliable noninvasive markers of significant restenosis after stent implantation. The effect of coronary revascularization on QTd in patients who underwent coronary stenting has not been investigated extensively. The aim of this study was to evaluate the value of QTd in predicting restenosis after intracoronary stent implantation. QTd with 12 lead surface ECG was measured in 48 patients (21 with restenosis and 27 without restenosis; 33 male; mean age, 58+/-10.8 years) before the procedure and after long-term follow-up (mean, 6.8+/-3.2 months). All patients had coronary angiographic control at the end of the follow-up period. QTd (as the difference between the maximum and minimum QT interval measured from 12 lead ECG) and rate-corrected QT (QTcd) were evaluated at rest. In 27 patients without restenosis, QTd and QTcd decreased from 58+/-14.4 and 62.8+/-20.4 ms to 26.3+/-9.2 and 29.6+/-10.6 ms in the long term follow-up, respectively (P<0.001). However, in 21 patients with restenosis, there was no significant change in QTd and QTcd intervals and they were still increased at the end of the long-term follow-up (P>0.05). In conclusion, increased QT interval dispersion may be an inexpensive and simple marker of restenosis after intracoronary stent implantation.

The effect of povidone iodine on the corneal endothelium.

PURPOSE: Povidone iodine has been proven to be a valuable antiseptic solution in preparing the eye for surgery and is an alternative to postoperative topical antibiotics. No study has addressed the intraocular toxicity of povidone iodine after injection into the anterior chamber. We investigated the potential toxicity of povidone iodine on the corneal endothelium after injections into the anterior chamber in a rabbit model. METHODS: In this study we used 24 eyes of 12 albino rabbits. The eyes were divided into the following three groups according to the drugs tested: group A, 5% povidone iodine; group B, 10% povidone iodine; group C, balanced salt solution. The injected eyes were evaluated by biomicroscopy, specular microscopy, corneal pachymetry, and transmission and scanning electron microscopy. RESULTS: Corneal edema was observed in all eyes of groups A and B. In groups A and C, the endothelial cell morphology was not significantly changed and the mean endothelial cell count of the eyes did not change significantly (p = 0.5054). There was no significant difference in corneal thickness between groups A and C (p = 0.3823), but there was a significant difference between groups B and C ( = 0.0002). Transmission and scanning electron microscopy results were normal in group C but not in groups A and B. CONCLUSION: Povidone iodine in both 5% and 10% concentrations demonstrates severe toxicity when one drop of either concentration is placed directly in the anterior chamber. When povidone iodine is used in preparing the eye for intraocular surgery and as an alternative to postoperative antibiotics, the inadvertent leakage of povidone iodine into the anterior chamber must definitely be prevented.

A fistula connecting the right coronary artery to the right atrium: a hitherto undescribed association.

A case of double right coronary artery accompanying a fistulous connection is presented. An additional right coronary artery is an extremely rare congenital abnormality. In this case, the second right coronary artery was draining into a cardiac chamber via a fistulous connection. This is the first case in the literature to present these abnormalities coexisting in the same patient.

Heart rate variability, late potentials and QT dispersion as markers of myocardial involvement in patients with Behçet's disease.

BACKGROUND: Myocardial involvement in Behçet's disease has been reported to be relatively rare. OBJECTIVE: To evaluate myocardial involvement noninvasively in patients with Behçet's disease by measuring signal-averaged electrocardiography (SAECG), QT dispersion and heart rate variability (HRV). PATIENTS AND METHODS: The study group comprised 28 eligible patients (16 male, mean age 37+/-13 years) of 33 patients with Behçet's disease, and 25 age- and sex-matched control subjects. RESULTS: The echocardiographic left ventricular measurements were within normal limits and similar in both groups except the E/A ratio, which was significantly lower in patients with the disease than in control patients. Minimal pericardial effusion was detected in four patients. Considering the SAECG recordings, values of root mean square voltage in the last 40 ms were 30+/-18 microV and 38+/-18 microV in patients with Behçet's disease and in the control group, respectively. The number of cases with a value less than 20 microV was seven (25%) and one (4%) in the same groups, respectively. Both QT dispersion and the corrected QT interval dispersion were significantly increased in patients with Behçet's disease compared with the control patients (50.2+/-16.6 versus 20.4+/-18.8, P<0.01). Although all HRV measures appeared to be decreased in the Behçet's group, only the standard deviation of all filtered RR intervals in the entire 24 h ECG recordings and the percentage of differences between adjacent filtered RR intervals that are greater than 50 ms for the whole analysis values differed significantly between the groups (P<0.05). No significant difference was observed in frequency domain parameters. In the Holter ECG recording, grade 2 or greater premature ventricular complexes were observed in seven patients from the Behçet's group (25%) but in only one subject from the control group (4%) (P<0.05). CONCLUSIONS: Patients with Behçet's disease appeared to have significantly increased QT dispersion, a left ventricular diastolic dysfunction pattern in echocardiography, a high incidence of positive late potentials and more complex ventricular arrhythmias, suggesting myocardial involvement and the existence of an arrhythmogenic substrate, whereas the HRV measures do not suggest a clear autonomic abnormality in Behçet's disease.

Efficacy of lodoxamide eye drops on tear fluid cytology of patients with vernal conjunctivitis.

A double-masked, randomized, placebo-controlled study was conducted to evaluate the effectiveness of lodoxamide tromethamine 0.1% eyedrops in preventing inflammatory cell accumulation in the tear fluid of patients with vernal conjunctivitis. A 1-week baseline period was followed by 4 weeks of treatment with either lodoxamide tromethamine 0.1% ophthalmic solution or placebo in 30 symptomatic subjects with vernal conjunctivitis. Cytological evaluation of tear fluid was performed before and after the treatment. In the lodoxamide-treated group, but not in the placebo-treated group, the number of neutrophils (P = 0.051) and eosinophils (P = 0.020) in the tears significantly decreased at the end of 4 weeks when compared with baseline (Wilcoxon-signed rank test). It was concluded that lodoxamide treatment was significantly more effective than the placebo in terms of reducing inflammatory cells in the tear fluid in vernal conjunctivitis. This objective inhibition of inflammatory cells may be associated with clinical relief.

Cardioversion with sotalol in selected patients with vagally and adrenergically mediated paroxysmal atrial fibrillation.

This study was designed to evaluate and compare the effects of oral sotalol for the treatment of vagal and adrenergic paroxysmal atrial fibrillation (PAF). Thirty-five eligible patients with atrial fibrillation of > 12 hours and < 7 days were enrolled in the study. Patients were classified as vagally mediated (group I, n: 14) and adrenergically mediated (group II, n: 21) PAF groups. All patients were given racemic sotalol at a dose up to 120 mg bid for 2 days. At the end of the observation period of 48 hours, 36% of patients (n: five) in group I returned to sinus rhythm. Conversion rate in group II was 71% (n: 15), and this figure was significantly higher than the success rate in group I. Mean times to cardioversion were 22 +/- 15 hours in group I and 16 +/- 14 hours in group II (p < 0.05). The result of this study suggests that oral sotalol is more effective for adrenergic PAF. This beneficial effect of sotalol is not apparent in vagal PAF patients.

The use of perfluorodecalin in retinal detachments with retinoschisis.

BACKGROUND AND OBJECTIVE: To evaluate the effect of perfluorodecalin on the repair of retinal detachments with retinoschisis. PATIENTS AND METHODS: Twenty-two eyes of 20 patients with degenerative and X-linked retinoschisis underwent pars plana vitrectomy, perfluorodecalin injection, internal fluid drainage, and fluid-air exchange. RESULTS: The retina was reattached intraoperatively in 21 (95.4%) of the 22 eyes. In 4 eyes, retinal detachment recurred within 2 months postoperatively. All of the recurrent cases underwent reoperation with perfluoropropane gas and the retina was reattached at the end of 2 operations. As a result, visual acuity increased in 18 (81.8%) of the 22 eyes. CONCLUSION: Perfluorodecalin makes flattening of the retina and evacuation of subretinal fluid easier in the management of rhegmatogenous retinal detachments associated with degenerative and X-linked retinoschisis.