Fabrication of Polycaprolactone-Based Polyurethanes with Enhanced Thermal Stability.

The benefit of being acquainted with thermal properties, especially the thermal stability of polyurethanes (PU), and simplified methods for their improvement is manifold. Considering this, the effect of embedding different amounts of unmodified and surface-modified TiO2 nanoparticles (NPs) within PU, based on polycaprolactone (PCL) and Boltorn® aliphatic hyperbranched polyester, on PU properties was investigated. Results obtained via scanning electron microscopy, swelling measurements, mechanical tests and thermogravimetric analysis revealed that TiO2 NPs can be primarily applied to improve the thermal performance of PU. Through surface modification of TiO2 NPs with an amphiphilic gallic acid ester containing a C12 long alkyl chain (lauryl gallate), the impact on thermal stability of PU was greater due to the better dispersion of modified TiO2 NPs in the PU matrix compared to the unmodified ones. Also, the distinct shape of DTG peaks of the composite prepared using modified TiO2 NPs indicates that applied nano-filler is mostly embedded in soft segments of PU, leading to the delay in thermal degradation of PCL, simultaneously improving the overall thermal stability of PU. In order to further explore the thermal degradation process of the prepared composites and prove the dominant role of incorporated TiO2 NPs in the course of thermal stability of PU, various iso-conversional model-free methods were applied. The evaluated apparent activation energy of the thermal degradation reaction at different conversions clearly confirmed the positive impact of TiO2 NPs on the thermal stability and aging resistance of PU.

Activity of paraoxonase 1 (PON1) on HDL2 and HDL3 subclasses in renal disease.

INTRODUCTION: Cardiovascular complications, as the main cause of mortality in renal patients, are followed with altered lipoproteins composition. Considering that paraoxonase-1 (PON1) is an anti-oxidative enzyme located mainly on HDL particles, the current study has aim to investigate whether failure of kidney function leads to changes in the distribution of PON1 activity between different HDL subclasses. MATERIALS AND METHODS: In 77 renal patients (21 chronic kidney disease (CKD) and 56 end stage renal disease (ESRD) patients on dialysis) and 20 healthy subjects PON1 activity on HDL2 and HDL3 subclasses was determined by zymogram method that combines gradient gel electrophoresis separation of HDL subclasses and measurement of PON1 activity in the same gel. RESULTS: Serum paraoxonase (p<0.01) and arylesterase activity (p<0.001) of PON1 as well as its concentration (p<0.01) were significantly lower in CKD and ESRD patients compared to controls. Relative proportion of HDL3 subclasses was higher in ESRD patients than in healthy participants, while HDL2 subclasses was significantly decreased in CKD (p<0.05) and ESRD (p<0.001) patients, as compared to controls. Furthermore, control subjects had higher PON1 activity on HDL2 (CKD and ESRD patients p<0.001) and HDL3 (CKD p<0.05; ESRD patients p<0.001) subclasses in comparison with the both patients groups. Also, significant negative correlation was found between paraoxonase activity of PON1 in serum and creatinine concentration (ρ=-0.373, p<0.01). CONCLUSIONS: This study showed that altered HDL subclasses distribution, changed PON1 activities on different HDL subclasses as well as diminished anti-oxidative protection could be important factors in atherosclerosis development in CKD and ESRD patients.

Apparent diffusion coefficient in the evaluation of cerebral gliomas malignancy.

BACKGROUND/AIM: Magnetic resonance imaging (MRI) is a key modality not only for lesion diagnosis, but also to evaluate the extension, type and grade of the tumor. Advanced MRI techniques provide physiologic information that complements the anatomic information available from conventional MRI. The aim of this study was to determine whether there is a correlation between apparent diffusion coefficient (ADC) maps of intracranial glial tumors and histopathologic findings and whether ADCs can reliably distinguish low-grade from high-grade gliomas. METHODS: This retrospective study included 25 patients with MRI examination up to seven days before surgery, according to the standard protocol with the following sequences: T1WI, T2WI, FLAIR, DWI and post contrast T1WI. Data obtained from DW MRI were presented by measuring the value of ADC. The ADC map was determined by utilizing Diffusion-Perfusion (DP) Tools software. All the patients underwent surgical resection of the tumor. Histological diagnosis of tumors was determined according to the World Health Organization (WHO) classification. The ADC values were compared with the histopathologic findings according to the WHO criteria. RESULTS: The ADC values of astrocytomas grades I (0.000614 +/- 0.000032 mm2/s) were significantly higher (< 0.001) than the ADC values of anaplastic astrocytomas (0.000436 +/- 0.000016 mm2/s) and the ADC values of glioblastomas multiforme (0.000070 +/- 0.000008 mm2/s). The ADC values of astrocytomas grades II (0.000530 +/- 0.000114 mm2/s) were significantly higher (< 0.001) than the ADC values of anaplastic astrocytomas (0.000436 +/- 0.000016 mm2/s) and glioblastomas multiforme (0.000070 +/- 0.000008 mm2/s). The ADC values of anaplastic astrocy-omas (0.000436 +/- 0.000016 mm2/s) were significantly higher (< 0.001) than the ADC values of glioblastomas multiforme (0.000070 +/- 0.000008 mm2/s). The ADC values in the cystic part of the tumor for astrocytomas grades I (0.000775 +/- 0.000023 mm2/s) were significantly higher (< 0.001) than the ADC values of anaplastic astrocytomas (0.000119 +/- 0.000246 mm2/s) and glioblastomas multiforme (0.000076 +/- 0.000004 mm2/s). The ADC values astrocytomas grades II (0.000511 +/- 0.000421 mm2/s) were significantly higher (< 0.001) than the ADC values of glioblastomas multiforme (0.000076 +/- 0.000004 mm2/s). CONCLUSION: DWI with calculation of ADC maps can be regarded as a reliable useful diagnostic tool, which indirectly reflects the proliferation and malignancy of gliomas. The ADCs maps can both predict the results of histopathological tumor and distinguish between low- and high-grade gliomas, and provide significant information for presurgical planning, treatment and prognosis for patients with high-grade astrocytomas.

Aseptic intrafascial and extrafascial abscesses 10 years after a 2-level DIAM insertion procedure.

With the aim to prevent the so-called adjacent-segment disease in spinal fusion surgery and to serve as the primary surgical procedure for the management of low-back pain syndrome or neurogenic claudication in spinal stenosis, the so-called dynamic spine stabilization is applied using specifically designed implants: interspinous spacers, such as DIAM (Device for Intervertebral Assisted Motion), Coflex, and X-stop. It is commonly accepted that interspinous spacers are made from material that is well tolerated by the body, that their placement is simple, that complications are rare, and that they can greatly benefit the patients. So far, there have not been published studies reporting infective or other complications 10 or more years after the placement of DIAM spacers. The aim of this paper was to present a case of an extremely late complication (after 10 years) in the form of intra- and extrafascial dumbbell abscesses, concomitantly appearing at both levels treated with the DIAM spacer. The paper presents the existence of a significant correlation between CT and MRI findings as well as the deterioration in Oswestry Disability Index and visual analog scale scores. Over time, dynamic spine stabilization might possibly impact reactive accumulation of sterile fluid in the vicinity of an implant and could therefore be related to delayed complications even 10 years after surgery. The finding of a growing layer composed of thick aseptic fluid around the DIAM implant, with a simultaneous occurrence of spinous process osteolysis and formation of a mineralized pseudocyst, bears a considerable risk of delayed inflammatory complications, including abscess, and therefore requires the explantation of the DIAM implant.

Terson's Syndrome - A Report of Two Cases.

INTRODUCTION: Vitreous or retinal hemorrhage occurring in association with subarachnoid hemorrhage is known as Terson's syndrome. In Terson's syndrome, intracranial hemorrhages are followed by intraocular hemorrhage, classically in the subhyaloid space, but may also include subretinal, retinal, preretinal, and vitreal collections. Vitreous hemorrhage recovery is usually spontaneous in six to 12 months, otherwise vitrectomy is considered. OUTLINE OF CASES: We report of two cases of Terson's syndrome. The.first was in a hypertensive middle-aged female, following anterior communicating artery aneurismal subarachnoid hemorrhage, after post-neurosurgical interventions.The second case report was of a young male who suffered from the bilateral vitreous hemorrhage after a severe traumatic brain injury. CONCLUSION: Terson's syndrome should be considered in patients who had previous cerebral hemorrhage and are referred to eye specialist because of loss of vision. However, this phenomenon has only rarely been described in association with subdural and epidural hematomas or traumatic subarachnoid hemorrhage.

Poly(urethane-dimethylsiloxane) copolymers displaying a range of soft segment contents, noncytotoxic chemistry, and nonadherent properties toward endothelial cells.

Polyurethane copolymers based on α,ω-dihydroxypropyl poly(dimethylsiloxane) (PDMS) with a range of soft segment contents were prepared by two-stage polymerization, and their microstructures, thermal, thermomechanical, and surface properties, as well as in vitro hemo- and cytocompatibility were evaluated. All utilized characterization methods confirmed the existence of moderately microphase separated structures with the appearance of some microphase mixing between segments as the PDMS (i.e., soft segment) content increased. Copolymers showed higher crystallinity, storage moduli, surface roughness, and surface free energy, but less hydrophobicity with decreasing PDMS content. Biocompatibility of copolymers was evaluated using an endothelial EA.hy926 cell line by direct contact, an extraction method and after pretreatment of copolymers with multicomponent protein mixture, as well as by a competitive protein adsorption assay. Copolymers showed no toxic effect to endothelial cells and all copolymers, except that with the lowest PDMS content, exhibited resistance to endothelial cell adhesion, suggesting their unsuitability for long-term biomedical devices which particularly require re-endothelialization. All copolymers exhibited excellent resistance to fibrinogen adsorption and adsorbed more albumin than fibrinogen in the competitive adsorption assay, suggesting their good hemocompatibility. The noncytotoxic chemistry of these synthesized materials, combined with their nonadherent properties which are inhospitable to cell attachment and growth, underlie the need for further investigations to clarify their potential for use in short-term biomedical devices.

Cervical epidural hematoma: case report.

INTRODUCTION: Cervical epidural hematoma is a rare phenomenon in children. MRI scan of the cervical spine is the method of choice in establishing diagnosis and a quick evacuation of hematoma and de- compression. CASE OUTLINE: We present a case of 11-year-old boy whose lower extremities were paralysed after a trivial injury of the cervical spine which he sustained while playing. Seven days after the injury, severe clinical symptoms appeared, and MRI of the spine showed the presence of cervical epidural hematoma. CONCLUSION: Cervical epidural hematoma in children is very rare. Adequate neurological examination, di- agnostics and urgent surgical intervention are of paramount importance for accomplishing good results. Early and persistent rehabilitation are the condition for achieving maximal recovery.

Morphological and functional outcome of scleral buckling surgery compared to primary vitrectomy in patients with retinal detachment.

BACKGROUND/AIM: Among the proposed operative techniques for retinal detachment (RD) the most commonly applied are classical method with scleral buckling and pars plana vitrectomy (PPV). The aim of this paper was to determine which surgical intervention of these two leads to better morphological results in terms of the applied retina and better functional outcomes in terms of visual acuity (VA) of the operated eye in patients with RD. METHODS: A retrospective study on the comparative section of the effects of scleral buckling surgery and PPV in uncomplicated rhegmatogenous RD was performed. In a 2-year period 97 patients, i.e. 98 eyes with RD were operated on (68 eyes with scleral buckling surgery vs 30 by PPV). RESULTS: In the group with classically operated detachment, the retina was applied in 52 (76.5%) cases vs 30 (100%) patients in PPV group (p < 0.05). Postoperative VA in logMAR was significantly better in both groups compared to preoperative VA: in the classically operated was 1.89 ± 1.04 preoperatively vs 0.98 ± 0.70 postoperatively, while in the PPV group, preoperative value was 2.56 ± 0.67 vs 1.31 ± 0.74 postoperatively (p = 0.001). CONCLUSION: PPV in uncomplicated forms of RD gives better anatomical results than scleral buckling surgery. VA was significantly improved in both observed groups, while its mean value was postoperatively better in the group that was operated with the classical method. The reason for this could be due to better VA in baseline in the scleral buckling surgery group.

De novo mutation in the NOTCH3 gene causing CADASIL.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is one of the most common hereditary forms of stroke, and migraine with aura, mood disorders and dementia. CADASIL is caused by mutations of the NOTCH3 gene. This mutation is inherited as an autosomal dominant trait. Most individuals with CADASIL have a parent with the disorder. In extremely rare cases, CADASIL may occur due to a spontaneous genetic mutation that occurs for unknown reasons (de novo mutation). We report a new case of patient with de novo mutation of the NOTCH3 gene and a condition strongly suggestive of CADASIL (migraine, stroke, and white matter abnormalities), except that this patient did not have any first-degree relatives with similar symptoms.

Glutathione S-transferase omega-2 polymorphism Asn142Asp modifies the risk of age-related cataract in smokers and subjects exposed to ultraviolet irradiation.

BACKGROUND: Glutathione S-transferase omega-1 and 2 have a unique range of enzymatic activities, including the regeneration of ascorbate by their dehydroascorbate reductase activities. Because these enzymes could have a protective role from oxidative damage in the lens, the question of whether the two coding glutathione S-transferase omega polymorphisms confer the risk of age-related cataract was addressed. METHODS: rs4925 (Ala140Asp) of glutathione S-transferase omega-1 and rs156697 (Asn142Asp) of glutathione S-transferase omega-2 polymorphisms in 100 patients with age-related cataract and 130 controls were assessed. RESULTS: Presence of one mutant GSTO1*Asp or GSTO2*Asp allele did not contribute independently towards the risk of cataract; however, homozygous carriers of GSTO1*Asp/GSTO2*Asp haplotype demonstrated 3.42-fold enhanced risk of cataract development (95% confidence interval = 0.84-13.93; P = 0.086). When GSTO genotype was analysed in association with smoking or professional exposure to ultraviolet irradiation, carriers of at least one mutant GSTO2*Asp allele had increased risk of cataract development in comparison with individuals with wild-type GSTO2*Asn/Asn with no history of smoking or ultraviolet exposure (odds ratio = 6.89, 95% confidence interval = 1.81-16.21, P = 0.005; odds ratio = 4.10, 95% confidence interval = 1.23-13.74, P = 0.022, respectively). Regarding the distribution of particular glutathione S-transferase omega genotype and cataract type, the highest frequency of mutant GSTO2*Asp allele was found in patients with nuclear cataract. CONCLUSION: The results indicate that mutant GSTO2*Asp genotype is associated with increased risk of age-related cataract in smokers and ultraviolet-exposed subjects, suggesting a role of inefficient ascorbate regeneration in cataract development.

Influence of intravitreal injection of bevacizumab on systemic blood pressure changes in patients with exudative form of age-related macular degeneration.

INTRODUCTION: The aim of our study was to examine blood pressure (BP) changes in hypertensive and nonhypertensive patients after intravitreal bevacizumab injections and to assess whether intravitreal bevacizumab carries an associated vascular risk in patients with exudative ocular disease. We also aimed to estimate the influence of gender. METHODS: The study included 57 patients with age-related macular degeneration who received an intravitreal injection of 1.25 mg (0.1 mL) of bevacizumab. We analyzed systolic and diastolic BP values separately. Patients were divided into males and females, and into hypertensives and normotensives based on their BP values. BP was measured before bevacizumab administration, and 10 minutes, 1 hour, 2 days, 7 days and 6 weeks after the injection. RESULTS: Males had a statistically significant decline in systolic BP values 1 hour and 6 weeks after drug administration (p<0.05). The most notable significant decline in diastolic BP values was for males and for normotensive participants 1 hour after drug administration (p<0.05), while the most notable decline in diastolic BP values for females and for hypertensive participants was 7 days after drug administration, with statistical significance only for hypertensive patients (p<0.01). For males it was noticed that a statistically significant decline in diastolic BP persisted after 6 weeks (p<0.05). CONCLUSIONS: An intravitreal bevacizumab injection is safe as regards BP changes over 6 weeks post administration. Regular follow up for 6 weeks should be mandatory in order to promptly recognize individuals who have changes in BP values and include them in BP treatment in order to prevent complications.

[Big intraocular foreign body: case report].

INTRODUCTION: Penetrated injuries are most difficult injuries of the eye. Intraocular foreign body (IOFB) may lodge in any of the structures it encounters, from anterior chamber to the retina and choroid. Notable effects caused by foreign body injury include traumatic cataract, vitreous liquefaction, retinal and subretinal hemorrhages, retinal detachment and development of endophtalmitis. CASE OUTLINE: A 49-year-old man sustained injury of the right eye with a piece of metal wire. On admission visual acuity was VOD: 1.0 and lower intraocular tension TOD = 6 mmHg (10-22 mmHg). Corneal entry wound was noticed near limb on 11 h with a prominating foreign body of 18 mm in length that passed through the iris, lens and vitreous. X-ray findings confirmed existence of a large foreign body extending along the entire length of the globe. IOFB removal was done with anatomic forceps. On postoperative detailed clinical examination we observed retinal rupture in the upper temporal quadrant fitting in the area of the IOFB damaged retina. Laser photocoagulation of retinal tear (laser retinal barrage) was done. Visual acuity on discharge was the same (1.0) and intraocular tension was within normal limits (10 mmHg). CONCLUSION: Penetrated injury of eye requires detailed examination of all eye structures, beginning from the anterior to posterior segment. Timely diagnosed ruptures of the posterior segment of eye before the development of traumatic cataract, and adequate therapeutic procedures prevent serious complications of IOFB penetrated eye injury such as retinal detachment and permanent reduction of visual acuity.

[Pars plana vitrectomy with extraction of intraocular foreign body in patients with siderosis of the eye: report of two cases].

INTRODUCTION: Penetrating injury is characterized by the existence of entry wound only, and it can be with or without an intraocular foreign body (IOFB). IOFB can lead to a mechanical injury of the eye and to cause infection or to manifest other toxic effects on intraocular structures. Iron and copper can dissolve and cause siderosis, i.e. chalcosis of the eye. Ocular siderosis is diagnosed by clinical and electroretinogram (ERG) findings. OUTLINE OF CASES: The first patient was a 37-year-old male who was injured by a metal foreign body. He presented at the Clinic two years after the injury. Visual acuity of the right eye (VOD) on admission was VOD=L+P+ (light projection). Pars plana phaco-vitrectomy with IOFB extraction was done. Visual acuity on discharge was VOD=3/60 cc + 7.50 Dsph=0.2. The second patient was a 55-year-old male who presented at the clinic 18 months after injury. On admission visual acuity in his left eye was VOS 1/60. Pars plana phacovitrectomy with IOFB extraction was done.Visual acuity on discharge was VOS=0.7 through the stenopeic slit. CONCLUSION: In penetrating injuries caused by a metal IOFB pars plana vitrectomy with IOFB extraction is indicated. In cases with IOFB, when visual acuity is preserved, the lens is transparent, while the eye is without signs of infection, urgent pars plana vitrectomy is not necessary. Such patients need regular followup with obligatory ERG findings.

[Intraocular foreign body removal: case report].

INTRODUCTION: An intraocular foreign body may traumatize the eye mechanically, introduce infection or exert other toxic effects on the intraocular structures. Removal of a metallic intraocular foreign bodies (IOFB) use an internal (vitrectomy followed by forceps or internal magnet use) or external approach (large electromagnet). OUTLINE OF CASES: A 51-year-old man sustained injury of the left eye by a metal foreign body. On admission visual acuity was normal (VOS = 1.0) and intraocular tension was within normal limits (TOS = 10 mmHg). Nasal scleral entry wound was noticed. Ultrasound of the left eye was done, which confirmed existence of IOFB laying nasally, next to the ciliary body. Extraction of IOFB with a big electric magnet was done. Visual acuity on discharge was the same (VOS = 1.0). Another man, aged 30 years, came to the clinic after injury of the left eye by a foreign body. On admission visual acuity was VOS = L + P+ (light and projection), TOS = 44 mmHg (higher), traumatic cataract, scleral entry wound, corneal edema, existence of IOFB and initial endophtalmitis. Lensectomia and vitrectomia via pars plana with IOFB extraction were done.Visual acuity on discharge was VOS = 5/60 with +6.50 Dsph = 0.3-0.4; TOS= 7 mmHg. CONCLUSION: Magnet removal is indicated in patients when IOFB is laying free in the vitreous body or stopped near the entry wound during injury without other complications. Internal approach--pars plana vitrectomy with forceps removal is used when IOFB is stuck either on the peripheral or posterior part of the retina or if there are some of aforementioned complications.

Persistent submacular fluid diagnosed with optical coherence tomography after successful scleral buckle surgery for macula-off retinal detachment.

Crataegus species have been widely used in herbal medicine, especially for the hearth diseases. In the present study, the effect of Crataegus aronia var. dentata Browicz extract on partially hepatectomized rats was investigated with biochemical and TUNEL apoptosis assays. The extracts of the plant at the concentrations of 0.5 and 1 ml/100 g body weight/day were administered orally to the two experimental groups including partially hepatectomized rats for 42 days. At the end of the experimental period, animals were sacrificed, blood was collected for the assessment of serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT), and the liver tissue was used for TUNEL assay. In biochemical assay, it was found a significant decrease in the levels of serum ALT and AST in the experimental groups. On the other hand, the plant extract did not cause any significant changes in the level of GGT in these groups. In apoptosis assay, TUNEL positive hepatocytes could not be detected in both experimental groups. The present findings can suggest that Crataegus aronia var. dentata Browicz extract can decrease the levels of serum ALT and AST and play a role in apoptosis of hepatocytes in the liver of partially hepatectomized rats. However, further studies are required to confirm the effects of the plant extract on hepatoprotection and apoptosis in the regenerating liver after partial hepatectomy in animal models.

[Risk of infection after placement of an extraventricular drainage catheter].

INTRODUCTION: The occurrence of infection after the placement of an extraventricular drainage (EVD) catheter can be a very serious problem in neurosurgery. OBJECTIVE: The aim of this study was to confirm that the use of special catheters with impregnated antibiotics decreased the percentage of infection. METHODS: The prospective study conducted at the Clinic of Neurosurgery in Nis in the period 2006-2009 is presented. Group 1 comprised of 43 patients in whom a commonly used system for EVD was applied. Group 2 comprised of 39 patients in whom the Rifampycin and Clindamycin impregnated EVD catheters were applied (Bactiseal catheters). RESULTS: In Group 1 infection occurred in nine patients, mainly caused by bacteria of Staphylococcus genus. In Group 2 only two patients developed infections caused by Acinetobacter. CONCLUSION: The use of Bactiseal EVD catheters considerably decreased the percentage of infection occurrence with prolonged EVD catheter drainage period.

Complications after angiogram-negative subarachnoid haemorrhage: comparative study of pretruncal and nonpretruncal hemorrhage patients.

INTRODUCTION: Subarachnoid haemorrhages (SAH) of unknown aetiology usually have a mild clinical presentation, favourable outcome and low complication rate. OBJECTIVE: The aim of this study was to analyse the complications in two forms of angiogram-negative spontaneous SAH: pretruncal (PNSAH) and nonpretruncal (NPNSAH). METHODS: The study group involved 18 patients with PNSAH and 16 patients with NPNSAH. CT scan was done within 72 hours from bleeding. All patients underwent four-vessel cerebral angiography. Repeat angiography was performed in five PNSAH and all NPNSAH patients. RESULTS: Twenty-nine patients were in grade I or II of the Hunt-Hess Scale (17 PNSAH and 12 NPNSAH). There was one case of rebleeding (NPNSAH patient), 10 cases of transient acute hydrocephalus (4 PNSAH and 6 NPNSAH). Cerebral vasospasm visualized by angiographies in two NPNSAH patients was local and mild, but was not found in PNSAH patients. Acute electrocardiography changes were found in 19 patients (significantly more frequently in NPNSAH than in PNSAH, 12 and 7 patients, respectively; p = 0.037). CONCLUSION: Cardiac problems following these types of SAH are more frequent than expected, and therefore cardiac monitoring is necessary.

Prognostic significance of intracranial pressure monitoring and intracranial hypertension in severe brain trauma patients.

Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. The study was prospective with groups randomized. There were 53% survivals in the intracranial pressure monitored patients and 34% in the control group, with no significant difference in the survival rate between the two groups (chi2=2.11; p=0.15; p>0.05). The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student's t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient's intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.

[Operation of traumatic cataract with metal foreign body in the lens].

INTRODUCTION: We present a patient with perforative eye injury, a metal foreign body in the lens and traumatic cataract. The paper emphasises the importance of phacoemulsification in case of patients with a traumatic cataract and the presence of a metal foreign body. CASE OUTLINE: A 41-year-old patient had a perforative wound of the cornea caused by a metal foreign body that also perforated the anterior lens capsule and remained in the paracentral anterior part of the lens. The injury, which happened upon hitting of a hammer against a metal object, showed the presence of a tangential wound of the cornea adapted edges, and a formed anterior eye chamber. The presence of a metal spear-shaped foreign body was partly inside the anterior eye chamber and partly in the central area of the lens. The visual acuity of the injured eye was 0.2. The technique of removing the foreign body out of the lens and the phacoemulsification of the lens with the implantation of intraocular lens is presented. The paracentral wound on the cornea was not sutured because of well-adapted edges. On the first postoperative day there were no inflammatory signs, and best uncorrected visual acuity of 0.8. CONCLUSION: Posttraumatic cataracts with a metal foreign body in the lens require operative treatment in order to remove the foreign body, phacoemulsification and implantation of artificial lens. Because of anterior capsule lesion, special care should be taken in regard to anterior capsulorhexis and appropriate hydrodisection. Ocular hypotonia and possible damage of the posterior capsule in some cases can make phacoemulsification more difficult to perform.

Bilateral retinal detachment in a case of preeclampsia.

Serous retinal detachment is an unusual cause of visual loss in preeclampsia. We report the case of 24-years-old primipara with severe preeclampsia who developed bilateral serous retinal detachment a few hours after delivery. A few weeks after delivery there was spontaneous resorption of the subretinal fluid and complete resolution bilateral serous retinal detachment, with residual pigmentary changes of the retinal pigment epithelium. Visual acuity was normal in each eye. The management of retinal detachment as a complication in preeclampsia is conservative and the prognosis is usually good.