Misoprostol ameliorates doxorubicin induced cardiac damage by decreasing oxidative stress and apoptosis in rats.

We investigated the potential cardioprotective effects of misoprostol (MP) on doxorubicin (DOX) induced cardiac damage using histologic and biochemical assessment of rat heart. We used 21 male rats divided randomly into three groups: group 1, control; group 2, DOX; group 3, DOX + MP. The control group was given 0.5 ml 0.9% NaCl intraperitoneally (i.p.) and 1 ml 0.9% NaCl orally for 6 days. DOX was administered as a single dose of 20 mg/kg i.p. on day 3. MP was administered orally for 6 days. We found that treatment with MP decreased significantly serum cardiac troponin-I, brain natriuretic peptide levels, and lactate dehydrogenase, aspartate aminotransferase, alanine transaminase and creatine kinase isoenzyme-MB activities. DOX increased the malondialdehyde level and decreased the catalase, superoxide dismutase activities and glutathione levels; MP prevented these alterations. MP also decreased NADPH oxidase-4 and caspase-3 levels. In the DOX + MP group, oxidative stress was decreased, antioxidant activity was increased and histopathological changes were decreased compared to the DOX group. Cardiac damage caused by DOX was attenuated by MP treatment owing to the antioxidative and anti-apoptotic effects of MP. MP may be useful for reducing the severity of DOX induced damage.

Effects of misoprostol treatment on doxorubicin induced renal injury in rats.

We investigated the potential nephroprotective effects of misoprostol (MP) on doxorubicin (DOX) induced renal injury using histologic and biochemical assessment of rat kidneys. We used 21 male rats divided into three groups: group 1, control; group 2, DOX; group 3, DOX + MP. The control group was given 0.5 ml 0.9% NaCl and 1 ml 0.9% NaCl orally for 6 days. DOX was administered as a single dose of 20 mg/kg on day 3. MP was administered orally for 6 days. We found that treatment with MP decreased serum creatinine and blood urea nitrogen levels significantly. DOX increased the malondialdehyde level and decreased catalase, superoxide dismutase activities and glutathione level. These alterations were prevented in renal tissues by MP. MP also decreased NADPH oxidase-4 and caspase-3 levels. In the DOX + MP group, oxidative stress was decreased, antioxidant activity was increased and histopathological changes were reduced compared to the DOX group. Renal injury caused by DOX was attenuated by MP treatment owing to the antioxidative and anti-apoptotic effects of MP.

Thymoquinone protection from amikacin induced renal injury in rats.

We investigated whether thymoquinone (TQ) exerts a beneficial effect on renal injury due to amikacin (AK) administration in rats. To generate kidney damage with AK, a single 1.2 g/kg dose of AK was administered intraperitoneally. TQ was administered orally to the AK treated group at a dose of 40 mg/kg for five days. At the end of the experiment, rats were sacrificed and blood samples were used to measure blood urea nitrogen (BUN) and creatinine (Cr) levels. Kidney samples were taken to measure the oxidative stress biomarker, malondialdehyde (MDA), and expression of the antioxidant enzymes, superoxide dismutase (SOD) and catalase (CAT). Because reactive oxygen species (ROS) and apoptosis contribute to tissue damage associated with NADPH oxidase (NOX), we also investigated NOX-2, NOX-4 and apoptosis marker, caspase-3, expression using immunohistochemistry. MDA, BUN, Cr, NOX-2, NOX-4 and caspase-3 production were increased, and SOD and CAT were decreased in the AK treated group compared to controls. MDA, BUN, Cr, NOX-2, NOX-4 and caspase-3 levels were decreased, and SOD and CAT levels were increased in TQ + AK treated rats compared to AK treated animals. TQ appears to protect the kidney from the toxic effects of AK.

The protective effect of misoprostol against doxorubicin induced liver injury.

We investigated the potential hepatoprotective effects of misoprostol (MP) on doxorubicin (DOX) induced liver injury in rats using histology and biochemistry. We used 21 male Sprague-Dawley rats divided randomly into three groups: group 1, control; group 2, DOX; group 3, DOX + MP. The control group was injected intraperitoneally (i.p.) with 0.5 ml 0.9% w/v NaCl and given 1 ml 0.9% NaCl orally for 6 days. DOX was administered i.p. as a single dose of 20 mg/kg. MP, 0.2 mg/kg, was given orally for 6 days. Treatment with MP increased high density lipoprotein cholesterol levels and decreased serum alanine aminotransferase, aspartate aminotransferase, low density lipoprotein cholesterol, triglycerides and total cholesterol levels significantly in serum. Increased malondialdehyde level and decreased catalase, glutathione and superoxide dismutase levels caused by DOX were suppressed significantly in liver tissue by MP. DOX + MP reduced loss of body weight. Oxidative stress was decreased, antioxidant activity was increased and histopathological changes were reduced in the DOX + MP group compared to the DOX group. Liver injury caused by DOX was attenuated by MP treatment owing to the antioxidative and anti-apoptotic effects of MP, which might be useful for reducing the severity of DOX induced liver injury.

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects.

OBJECTIVES: The aim of the study was to investigate the possible protective qualities of thymoquinone (TQ) against the side-effects of olanzapine (OLZ) in an experimental model in rat liver with histologic and biochemical assessments. METHODS: Experimental procedures were performed on 35 female Sprague Dawley rats. Rats were randomly divided into five groups as: group 1: control; group 2: OLZ; group 3: OLZ+TQ-1; group 4: OLZ+TQ-2; and group 5: OLZ+TQ-3. RESULTS: The results showed that a 2­week administration of OLZ (4 mg/kg, once a day for the first week, 8 mg/kg once a day for the second week, p.o.) and treatment with TQ (25, 50, 100 mg/kg, once daily, p.o.) significantly reduced weight gain induced by OLZ. In addition, TQ increased the total antioxidant status (TAS), high-density lipoprotein cholesterol (HDL), insulin levels and decreased serum oxidative stress index (OSI), total oxidant status (TOS), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), low density lipoprotein cholesterol (LDL), glucose, triglycerides (TG) and total cholesterol (CH) levels significantly (p < 0.05). CONCLUSION: This study revealed that treatment with TQ might protect liver tissue against the side-effects of OLZ. TQ could be an effective course of therapy to enhance therapeutic efficacy (Tab. 4, Fig. 4, Ref. 47).

Thyroid Hormone Levels in Chronic Schizophrenic Patients: Association with Psychopathology.

OBJECTIVES: Thyroid disorders are highly prevalent in patients with schizophrenia. Changes in the levels of thyroid hormones cause the occurrence of psychiatric disorders and affect the response to treatment. The aim of this study was to investigate the changes in thyroid hormone levels in patients with chronic schizophrenia, and to demonstrate any association between psychiatric symptoms and hormones. METHODS: Sixty-three patients with schizophrenia and 53 controls were included in this study. The serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in patients and controls were tested by using the chemiluminescence immunoassay. Symptoms were assessed via the Positive and Negative Syndrome Scale (PANSS). RESULTS: The level of FT4 in the schizophrenia group was statistically significantly lower than the control group (p = 0.045). There was no significant difference between the clinical subtypes of schizophrenia and thyroid hormone levels. There was a mild negative correlation between PANSS negative subscale scores and levels of TSH (p = 0.023). CONCLUSION: These findings suggest that the subclinical hypothyroidism observed in the chronic schizophrenic patients may be associated with the treatment of neuroleptics. The possible alterations of thyroid hormones should be considered in chronic schizophrenic patients for treatment with neuroleptics.

Difference between Spinecor brace and Thoracolumbosacral orthosis for deformity correction and quality of life in adolescent idiopathic scoliosis.

Although there are several conservative treatment options, only bracing has been found to be effective in preventing curve progression and a subsequent need for surgery in adolescent idiopathic scoliosis. The objective of this study is to compare the results of SpineCor brace and thoracolumbosacral orthosis (TLSO) for treatment of adolescent idiopathic scoliosis radiologically and clinically. Sixty-four patients with adolescent idiopathic scoliosis treated with brace included in this study. Height, T1-Coccygx distance, and gibbosity were measured. Rib hump deformity was evaluated with a scoliometer. An SRS-22 questionnaire was used to determine the quality of life of patients after the first year of brace treatment. Differences in Cobb angles and gibbosity were insignificant for both groups. SRS-22 questionnaire results showed significant differences in pain, self-image and function/activity subgroups. Patients' mental health and satisfaction scores were insignificant. These braces have a similar effect on deformity correction. The surgery rates and success rates of braces are approximately equal. The major difference between SpineCor and TLSO is health-related quality of life.

Spiral-medial butterfly fractures (AO-12-B1) in distal diaphysis of humerus with rotational forces: preliminary results of open reduction and plate-screw fixation.

OBJECTIVE: Humerus shaft fractures are frequent injuries in orthopedic practice and generally occurs with direct and indirect traumas. While the most of these fractures can be managed with conservative methods, in some situations surgery is needed. The aim of this study is to define a different mechanism and treatment result of  humerus spiral fractures with medial butterfly fragment (AO-12-B1). PATIENTS AND METHODS: Between 2010 and 2013, 11 patients who had undergone surgery for spiral humerus shaft fracture with medial large butterfly fragment (AO type 12-B1) resulting from a motor vehicle accident were enrolled to the study. All data was retrieved from the hospital's database retrospectively. All fractures were closed type and all of the patients were treated with open reduction and plate osteosynthesis through lateral approach. Elbow and shoulder ROMs were examined for functional outcomes. The DASH (Disabilities of the Arm, Shoulder and Hand) scoring system was applied at the final follow-up visit. RESULTS: There were 7 male and 4 female patients with a mean age of 36 years (range, 28-50 years). All of the fractures occurred with same mechanism resulting from motor vehicle accident. Conservative treatment was not considered for any of the cases. The mean time to surgery was 2 days (1-3 days). The mean postoperative follow-up period was 14 months (6-24 months). All fractures had healed completely at 3 months postoperatively. At the final follow-up visit the mean DASH score was 4.2 (3.3-6.7). CONCLUSIONS: Humerus spiral shaft fractures with a large medial butterfly fragment can be seen in dashboard injuries. It is important to fix the medial large fragment anatomically and minimal invasively in order to achieve union and not to disturb the vascular supply.

Preventive and early therapeutic effects of ß-glucan on the bleomycin-induced lung fibrosis in rats.

OBJECTIVE: The ß-glucans are long-chain polymers of glucose, which comprise the fungal cell wall, stimulate cells of the innate immune system, enhance disturbed epithelization, and have antioxidant effects. Oxidative stress has been implicated in the pathogenesis of bleomycin-induced lung fibrosis and various antioxidant agents have been studied for prevention and treatment of the disease. In this experimental animal study, we assessed effects of ß-glucan, extracted from barley, on the bleomycin-induced lung fibrosis, and evaluated differences of starting before and after bleomycin instillation. MATERIALS AND METHODS: Male Spraque-Dawley rats were given a single dose of bleomycin in pulmonary fibrosis groups. First dose of ß-glucan and NAC was given three days before the bleomycin injection, and at one of the other group ß-glucan was started 12 hours after bleomycin and continued until 14th day. Fibrotic changes in lung were estimated by using Aschoft's criteria and measuring lung hydroxyproline content. RESULTS: Bleomycin induced severe pulmonary fibrosis with marked increase in hydroxyproline content of lung tissue and typical lung fibrosis, which was prevented by ß-glucan. Hydroxyproline level was significantly higher in bleomycin treated rats than the other groups, and its level was decreased in the therapeutic groups, especially in the ß-glucan post-bleomycin group fibrosis score, hydroxyproline and MDA levels returned to the control levels. On the other hand, reduced glutathione level elevated in the same group. CONCLUSIONS: The data suggest that ß-glucans have protective and early therapeutic effects against bleomycin-induced lung fibrosis in rats.

Estimation of nasal cavity and conchae volumes by stereological method.

BACKGROUND: Studies evaluating the mean volumes of nasal cavity and concha are very rare. Since there is little date on the mentioned topic, we aimed to carry out the presented study to obtain a volumetric index showing the relation between the nasal cavity and concha. MATERIAL AND METHODS: The volumes of the nasal cavity and concha were measured in 30 males and 30 females (18-40 years old) on computed tomography images using stereological methods. RESULTS: The mean volumes of nasal cavity, concha nasalis media, and concha nasalis inferior were 5.95 ± 0.10 cm(3), 0.56 ± 0.22 cm(3), and 1.45 ± 0.68 cm(3); 7.01 ± 0.18 cm(3), 0.67 ± 0.31 cm(3) and 1.59 ± 0.98 cm(3) in females and males, respectively. There were statistically significant differences in the volume of the nasal cavity and concha nasalis media (p 〈 0.05) between males and females, except for concha nasalis inferior (p 〉 0.05). CONCLUSIONS: Our results could provide volumetric indexes for the nasal cavity and concha, which could help the physician to manage surgical procedures related to the nasal cavity and concha.

Right common iliac artery stenosis and stent insertion in Behçet's disease.

Behçet's disease is a multisystem inflammatory disorder that is classified among the vasculitides and can affect all types and sizes of blood vessels. Vascular manifestations of Behçet's disease are venous and arterial occlusion, and arterial aneurysms. As vasculitis of the vasa vasorum is the main pathological hallmark of Behçet's disease, it is generally seen as superficial thrombo-phlebitis or occlusion of the major veins; however arterial obstruction and aneurysms may also be seen to a lesser extent. Iliac artery stenosis is highly uncommon. Here, a case of common iliac stenosis in a 48-year-old patient with Behçet's disease is reported. As the risk of aneurysm during an operation was high in this patient, he was treated with vascular stent implantation. Due to stent occlusion two months after the operation, percutaneous transluminal angioplasty was performed with an 8-mm balloon. During the three-year follow up, no obstruction was observed.

Effects of Saccharomyces cerevisiae extract on haematological parameters, immune function and the antioxidant defence system in breeder hens fed aflatoxin contaminated diets.

The study was conducted to investigate the efficacy of Saccharomyces cerevisiae extract (SC) on haematological parameters, immune function, and the antioxidant defence system in breeder hens fed a diet contaminated with low level aflatoxin (AF). Forty-eight Ross 308 breeder hens were fed on diets containing AF (0 or 100 µg/kg) and SC (0 or 1 g/kg) in a 2 × 2 factorial arrangement. Red blood cell (RBC), white blood cell (WBC), and platelet counts, differential leucocyte counts, blood CD3+, CD4+, CD8+ and CD5+ T cell ratios, phagocytic activity and oxidative burst of heterophils, plasma and liver catalase activity, and malondialdehyde (MDA) and ascorbic acid concentrations were measured. 3. Plasma and liver MDA concentrations increased (P < 0·05), liver catalase activity decreased (P < 0·05) and total WBC count tended to decrease (P = 0·082) in hens fed the contaminated diet. WBC count, monocyte percentage, phagocytic activity and oxidative burst of heterophils increased (P < 0·05), and plasma MDA concentration tended to decrease (P = 0.088) in SC extract supplemented hens. There was a significant interaction between AF and SC on heterophil, lymphocyte, CD5+ cell percentages, and plasma catalase activity. Blood heterophil percentage decreased but lymphocyte percentage increased in hens fed on the AF contaminated diet without SC supplementation. SC supplementation counteracted the negative effect of AF on heterophils and lymphocytes. The CD5+ cell percentage decreased in unsupplemented hens fed the AF contaminated diet and this negative effect was minimised in SC supplemented hens. Plasma catalase activity increased in SC supplemented hens fed the uncontaminated diet whereas the effect of SC decreased in hens fed the AF contaminated diet. 4. The SC reduced some of the some adverse effects of AF, and improved functions of the non-specific immune system. Therefore, the SC extract which has been used for improving productive performance in birds and mammals may also be useful for modulating some of the effects of a low level, chronic dosage of AF.

Peripheral immune response in pulmonary tuberculosis.

Cellular immune response and delayed-type hypersensitivity reactions are considered to play a major role in the immunopathogenesis of pulmonary tuberculosis (PTB). But the exact mechanism is still to be clarified. Th1 cells are mainly involved in cellular immune responses in PTB and provide a normal healing process with minimal or no sequela whereas Th2 cell and CD8(+) T lymphocyte responses may lead to more severe type of disease. In this study, we investigated the peripheral blood immune responses in PTB. The study group consisted of acid fast positive young male soldiers with PTB and a negative HIV serology. The control group included healthy young volunteer male soldiers without a history of PTB. Intracytoplasmic cytokine content of CD8(+) T cells and lymphocytes, including IL-2, IL-4, IL-5, IL-10 and IFN-gamma were determined by flow cytometry, and IL-2, IL-4, IL-5, IL-10, IFN-gamma and TNF-alpha serum levels were measured by cytometric bead array (CBA). No difference was observed between the percentages of T, B, NK cells and HLA-DR expression in both groups, however, the number of CD3(+)HLA-DR(+) activated T cell percentages was higher in PTB group as compared to healthy subjects. IL-2, IL-4, IL-5, IL-10 contents of lymphocytes and IFN-gamma(+)CD8(+) T cells were found to be significantly lower in PTB patients when compared with healthy subjects, and in parallel, serum IL-2, IL-4, IL-5 and TNF-alpha levels were also significantly lower in PTB patients. In conclusion we suggest that, CD8(+) T cells producing both Th1 and Th2 type cytokines, may play important role in the peripheral immune response to mycobacteria.

Intracytoplasmic cytokine levels and neutrophil functions in early clinical stage of type 1 diabetes.

Studies indicate that both CD4(+) and CD8(+) T lymphocytes and their cytokines play a critical role in different clinical stages of type 1 diabetes (T1D). Disturbances of oxidative burst and phagocytic activities in neutrophils of diabetic patients compared to uncontrolled disease support the importance of neutrophil functions in the treatment and follow up of diabetic patients. This study is designed in order to investigate Th1 and Th2 cytokine profiles and neutrophil functions in early clinical stage of T1D. Patients diagnosed as T1D but not yet under insulin therapy (Group 1; n=15) and T1D patients with disease duration of <3 months (Group 2; n=20) were compared to healthy subjects (Group 3; n=15). All subjects with T1D were positive for islet cell antibody (ICA) and glutamic acid decarboxylase antibody (GADA), their fasting glucose levels were >126 mg/dl and A1(c) levels were >8. Intracytoplasmic interleukin (IL)-2, IL-10, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha levels of isolated CD4(+) and CD8(+) T cells, and neutrophil functions were determined by flow cytometry. Intracellular TNF-alpha level of CD4(+) T lymphocytes was significantly decreased in Group 1 compared to Group 2 and healthy subjects. In contrast, TNF-alpha in CD8(+) T lymphocytes was higher in Group 1 compared to Group 2. Increased TNF-alpha content of CD8(+) T lymphocytes was also obtained in Groups 1 and 2 compared to healthy subjects. Increased TNF-alpha secretion of CD8(+) T cells might reflect the role of CD8(+) T cells in beta cell destruction. Similar to cytokine content, phagocytic and oxidative burst activities in Group 1 were significantly lower compared to Group 2 and healthy subjects. Impaired neutrophil functions could be recovered by the treatment of the disease.

Comparison of four methods for the estimation of intracranial volume: a gold standard study.

Investigators can infer how much reduction in volume has occurred since brain volume was at its peak, by combining measures of brain volume with measures of intracranial volume (ICV). Several methodologies have been proposed to asses the ICV. However, we have not seen a gold-standard study evaluating the results of the methodologies for the assessment of ICV. In the present study, the actual intracranial volume of 20 dry skulls was measured using the water-filling method, using this as a gold standard. Anthropometry, cephalometry, point-counting, and planimetry techniques were applied to the same skulls to estimate the ICV. Anthropometric and cephalometric measurements were carried out directly on skulls and roentgenograms, respectively. Consecutive computed tomography sections at a thickness of 10 mm were used to estimate the ICV of the skulls by means of the point-counting and planimetry methods. The mean (+/-SD) of the actual ICV measured by the water-filling method was 1,262.0 +/- 160.4 cm(3) (1,389.5 +/- 96.5 cm(3) for males and 1,134.5 +/- 94.3 cm(3) for females, respectively). Our results showed that the estimated values obtained by all four methods differed from the actual volumes of the skulls (P < 0.05). The data obtained by anthropometry resulted in overestimation. However, cephalometry, point-counting, and planimetry methods produced underestimation. After calibration, there were no significant differences between the actual volumes and the results of the four methods (P > 0.05). While the anthropometric method is easy and quick to apply, its result may deviate from the actual values. The optimized stereological techniques of point-counting and planimetry methods may provide unbiased ICV results since they take the third dimension of the structures into account.

[Multiple bilateral retinomas. A case study]. / Rétinomes multiples et bilatéraux. A propos d'une observation.

The case of an asymptomatic 29-year-old male patient with bilateral multiple retinomas is described. Initially misdiagnosed as unilateral pathological myopia 10 years earlier, his ocular tumors were recognized only when examined after detection of bilateral retinoblastoma in his daughter. There was a large gray translucent mass and extensive chorioretinal atrophy in the right fundus and four small discrete tumors in the nasal periphery of the left fundus. There was no progression over 4 years of follow-up. Timely and correct diagnosis of retinoma is essential for appropriate genetic counseling, which would minimize the risk of retinoblastoma in future generations.

Different natural killer (NK) receptor expression and immunoglobulin E (IgE) regulation by NK1 and NK2 cells.

Many studies concerning the role of T cells and cytokines in allergy have been performed, but little is known about the role of natural killer (NK) cells. Accordingly, the expression of co-stimulatory, inhibitory and apoptosis receptors, cytokine profiles and their effect on immunoglobulin isotypes were investigated in polyallergic atopic dermatitis (AD) patients with hyper immunoglobulin E (IgE) and healthy individuals. AD patients showed significantly decreased peripheral blood NK cells compared to healthy individuals. Freshly isolated NK cells of polyallergic patients spontaneously released higher amounts of interleukin (IL)-4, IL-5, IL-13 and interferon (IFN)-gamma compared to healthy individuals. NK cells were differentiated to NK1 cells by IL-12 and neutralizing anti-IL-4 monoclonal antibodies (mAb), and to NK2 cells by IL-4 and neutralizing anti-IL-12 mAb. Following IL-12 stimulation, NK cells produced increased levels of IFN-gamma and decreased IL-4. In contrast, stimulation of NK cells with IL-4 inhibited IFN-gamma, but increased IL-13, production. The effect of NK cell subsets on IgE regulation was examined in co-cultures of in vitro differentiated NK cells with peripheral blood mononuclear cells (PBMC) or B cells. NK1 cells significantly inhibited IL-4- and soluble CD40-ligand-stimulated IgE production; however, NK2 cells did not have any effect. The inhibitory effect of NK1 cells on IgE production was blocked by neutralization of IFN-gamma. Except for CD40, NK cell subsets showed different expression of killer-inhibitory receptors and co-stimulatory molecules between the polyallergic and healthy subjects. These results indicate that human NK cells show differences in numbers, surface receptor and cytokine phenotypes and functional properties in AD.

[Ciliary body leiomyomas. Three case reports]. / Léiomyome du corps ciliaire. A propos de trois cas.

We present our experience with three patients, two of whom were women, 16, 28 and 44 years of age, presenting with leiomyomas of the ciliary body. Salient clinical features were involvement of the left eye and temporal quadrants in two cases and extension into the anterior chamber in the other. Two patients underwent enucleation and the third had iridocyclochoroidectomy. Immunohistochemical studies showed strong positivity for muscle-specific actin, smooth muscle actin and desmin, whereas staining against vimentin, HMB-45 and S-100 protein was negative. Although there are no specific clinical or imaging signs for intraocular leiomyoma, this tumor should be suspected when pigmented ciliary body tumors are encountered, especially in young female patients.

Percutaneous transluminal angioplasty of the inferior right hepatic vein for the treatment of Budd-Chiari syndrome.

Budd-Chiari Syndrome is one of the several causes of portal hypertension and is characterised by hepatomegaly, ascites and abdominal pain. The treatment requires either medical or interventional/surgical procedures. A case of Budd-Chiari Syndrome with a membranous web that causes obstruction in the ostium of the inferior right hepatic vein is reported here which was treated by percutaneous transluminal angioplasty (PTA). The patient was asymptomatic and off medication and there was no recurrence after 18-months follow-up.

Transpupillary thermotherapy in the management of choroidal metastases.

PURPOSE: To report the authors' experience in the use of infrared diode laser transpupillary thermotherapy in the management of selected posterior choroidal metastatic tumors. METHODS: Seven eyes of seven patients were treated using 810 nm infrared diode laser. Spot sizes of 0.5 to 3 mm were selected, each lasting 1 minute. When necessary, the treatment was repeated at 8- to 10-week intervals. Disappearance of the tumor was the main outcome measure. RESULTS: The primary sites of carcinomas were breast, prostate, and lungs. The largest basal diameters of ocular tumors varied between 5 mm and 10 mm and the thickness ranged between 2 mm and 4.5 mm. A mean power of 612 mW was used in one to four treatment sessions. In six eyes the tumors were reduced into flat scars whereas in one case the tumor continued to grow necessitating external beam radiotherapy. In three eyes the visual acuity decreased and in three eyes the vision became better. In one eye the vision was restored after external beam radiotherapy with the disappearance of extensive subretinal fluid. There were no immediate postoperative complications. CONCLUSIONS: Transpupillary thermotherapy can be a reliable, convenient, and cost-cutting option in the management of small, solitary choroidal metastatic tumors with a thickness of less than 3.5 mm and which have minimal subretinal fluid. Although successful in terms of tumor control, treatment close to the fovea or optic nerve head may cause a permanent decrease in visual acuity.