Exercise Training, Intermittent Fasting and Alkaline Supplementation as an Effective Strategy for Body Weight Loss: A 12-Week Placebo-Controlled Double-Blind Intervention with Overweight Subjects.

BACKGROUND: Intermittent fasting (IF) combined with exercise has been suggested to enhance weight loss. However, both procedures might negatively influence acid-base status. The aim of this study was to determine the combined effects of IF, exercise training and alkaline supplementation in overweight subjects on body composition and running performance. METHODS: 80 overweight subjects of age 45.5 ± 7.8 years were assigned to IF or non-intermittent fasting (nIF). Furthermore, subjects were randomly assigned to take either an alkaline supplement (IF-v, nIF-v) or a placebo (IF-p, nIF-p) twice a day. All subjects performed a personalized endurance exercise program (3-4 times/week for 12 weeks). Body weight, body composition, running performance and acid-base parameters were determined before (pre) and after the 12-week program (post). RESULTS: 68 participants completed the study. There was a significant effect on body weight loss, body fat loss, visceral fat loss and running performance enhancement in all groups (p < 0.01) for pre and post measurements. Body weight decreased in all groups (IF-p: -5.80 ± 0.77 kg and nIF-p: -3.40 ± 0.58 kg; IF-v: -8.28 ± 0.75 kg and nIF-v: -5.59 ± 0.87 kg). In both dietary strategies, weight loss was significantly further enhanced by alkaline supplementation. The increase in running velocity was significantly higher in IF combined with alkaline supplementation (IF-v 1.73 ± 0.23 km/h and IF-p 0.97 ± 0.20 km/h). In addition, alkaline supplementation increased plasma HCO3- concentration and urinary pH. CONCLUSION: Exercise training in combination with IF and alkaline supplementation is an effective strategy to reduce body weight and improve running performance in a 12-week intervention.

Ultrasound biomicroscopy of tangential keratotomy incision depth after penetrating keratoplasty.

PURPOSE: To assess the accuracy and reproducibility of using ultrasound biomicroscopy to measure corneal refractive incisions in vivo. SETTINGS: Department of Ophthalmology, University of Vienna, Austria. METHODS: Ultrasound biomicroscopy was performed in five eyes of five patients who had previous tangential keratotomy for high postkeratoplasty astigmatism. Depth of the incision scar was documented, and the measurements were compared with those obtained preoperatively by ultrasound pachymetry readings of the corneal thickness and with the settings of the diamond knife blade. RESULTS: The measured depths reached 84.7% +/- 12.9 (SD) of corneal thickness compared with the intended 89.1 +/- 6.7% depth of incision. The relation between knife setting and achieved depth was 95.3 +/- 15.9%. CONCLUSION: Ultrasound biomicroscopy provided high-quality images of the incision scars, accurately measuring actual incision depth in vivo. It may become a clinically useful tool for the refractive surgeon as it contributes to the predictability and accuracy of keratorefractive procedures.

[Combined therapy with cyclosporin A and cortisone in endocrine Basedow endocrine orbitopathy: successful use in compressive optic neuropathy]. / Kombinierte Therapie mit Cyclosporin A und Kortison bei der endokrinen Orbitopathie des Morbus Basedow: erfolgreicher Einsatz bei der kompressiven Optikusneuropathie.

This study reports our experience with a combined treatment with cyclosporin A (Cy A) and cortisone in patients with Graves' ophthalmopathy (GO), all of whom had compressive optic nerve disease (CON). The therapy was performed in 8 patients (6 females, age range: 40 to 76 years) with normal liver and kidney function and classical Graves' disease, except for 1 male, who had normal thyroid function and no detectable thyroid antibodies. 5 patients were euthyroid on methimazole, 2 patients were off thyrostatic treatment for 5 and 2 years. 3 patients have had high-dose cortisone (100 mg/die) treatment for GO before the study. Visual field defects were reported by the patients 1 week before start of therapy and evaluated by computerized visual field measurements (CVFM). The treatment consisted of Cy A in a dose which aimed at through levels between 100 and 300 ng/ml (RIA method) for 2 to 6 months and of methylprednisolone in a starting dose of 1 mg/kg body weight, tapered gradually to a maintenance dose of 10 mg/day for 6 to 12 months. CON disappeared completely in all patients. The thickening of affected eye muscles decreased in 5 patients, disappeared in 1 and remained unchanged in 2 patients. The shortest period for a measurable effect (either by echography or by CVFM, performed every week the first month and then every 3 months) was 1 week; the longest 1 month. The follow-up of the patients (range 6 months to 2.5 years) showed a relapse only in 1 patient. 2 patients were lost to follow-up 1 year after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of bronchial effects following topical administration of butylamino-phenoxy-propanol-acetate, an oculoselective beta-adrenoceptor blocker in asthmatic subjects.

1. Butylamino-phenoxy-propanol-acetate (BPPA) is a new topical oculoselective beta-adrenoceptor blocker for the reduction of intraocular pressure (IOP) in man. Its potency on the airways of normal subjects was identical with that of placebo. A study was carried out to determine the potential of BPPA to cause bronchoconstriction in mild asthmatics (FEV1 greater than or equal to 60% predicted) with normal IOP. 2. Twelve nonsmoking outpatients who bronchoconstricted to 0.25 or 0.50% of timolol eye drops (fall in FEV1 23.33 +/- 1.20% (mean +/- s.e. mean), range 16-30) were investigated in this double-masked, randomized, 3-period, crossover study. On three different occasions six incremental concentrations of BPPA (range: 0.1-2%; maximum cumulative concentration 4%), timolol (0.1-1%; 2%), and placebo were administered bilaterally until bronchoconstriction (decrease in FEV1 greater than or equal to 20% and in specific airway conductance (sGaw) greater than or equal to 35% simultaneously) or the maximum cumulative concentration was reached. 3. Airway response was measured as change in FEV1 and sGaw and dose-response curves to timolol, BPPA and placebo were performed. IOP was measured 3 h after the highest concentration of each study day. 4. Timolol caused dose-dependent falls in FEV1 and sGaw as well as clinical symptoms of respiratory distress in all subjects. The median cumulative concentrations of timolol required to decrease FEV1 by 20% and sGaw by 35% were 0.98% and 1.53%. Neither placebo (P greater than 0.05) nor BPPA (P greater than 0.05) caused a significant change in sGaw. A fall in FEV1 by 20% not accompanied by a simultaneous fall in sGaw by 35% was found in four subjects following BPPA and in five subjects following placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of systemic effects of different ophthalmic beta-blockers in healthy volunteers.

Systemic beta-blockade after single doses of ophthalmic beta-blockers (one drop in each eye) was investigated in healthy volunteers in two randomized, double-blind, crossover, placebo-controlled studies. beta-Blockade was evaluated by displacement of the bronchodilator (specific airway conductance), positive chronotropic (heart rate), and tremorogenic (finger tremor amplitude) dose-response curve for inhaled isoproterenol. In study 1, 0.5% betaxolol, 0.6% metipranolol, and 0.5% timolol were tested in 16 subjects. Compared with placebo, all beta-blockers resulted in a significant systemic beta-blockade (p greater than 0.05); the increasing order of potency was betaxolol, metipranolol, and timolol. In study 2, 2% butylamino-phenoxy-propanol-acetate (BPPA; a noncardioselective but topically oculoselective drug) and 1% timolol were investigated in 12 subjects. Placebo and BPPA showed no differences (p greater than 0.05), whereas timolol resulted in a significant beta-blockade (p less than 0.05). Topical oculoselectivity is an important aspect of drug safety of beta-blocking eyedrops. Measure of tremor is appropriate to evaluate beta 2-blockade.

[Complications following orbital floor fractures]. / Komplikationen nach Orbitabodenfrakturen.

Complications after orbital floor fractures were studied in 76 cases (follow-up time 4 years). The following procedures were performed by the maxillofacial surgeon: repositioning of the orbital floor, tamponade of the maxillary sinus, covering of the defect with Lyodura, autologous bone grafting, and balloon catheterization. A satisfactory result was achieved after the primary operation in 75% of the cases. In cooperation with the ophthalmologist a variety of complications in 19 patients were studied and analyzed. The results of this study show the necessity of diagnostic and surgical cooperation between the specialists concerned.

[Significance of echographic tissue differentiation for orbital surgery]. / Die Bedeutung der echographischen Gewebsdifferenzierung für die Orbitachirurgie.

The high degree of accuracy of standardized echography in tissue differentiation of orbital tumors enables the ophthalmic surgeon to determine exactly whether or not orbitotomy is indicated. As a result of the echographic examination the ophthalmologist is optimally informed as to the location, extent, delimitation and nature of the tissue of the tumor, and therefore better able to perform the orbitotomy. Standardized A-scan echography is capable of demonstrating an orbital tumor with 99% accuracy. Its location, limits, and tissue differentiation decide whether conservative or surgical treatment is to be preferred. Orbital tumors in any location can be removed by Krönlein's temporal orbitotomy: the wide temporal approach enables even large tumors to be excised in toto. With appropriate care much of the orbital contents can be spared and an optimal functional and cosmetic result achieved.

[Developmental status and clinical significance of ultrasound diagnosis of intraocular diseases]. / Entwicklungsstand und klinische Bedeutung der Ultraschalldiagnostik bei intraokularen Erkrankungen.

Standardized echography is a special method of ultrasonic diagnosis developed for the purpose of ophthalmic tissue differentiation. It is a combination of A-scan 7200 MA (Kretztechnik) and a contact real-time B-scanner (Bronson-Turner). The special design and standardization of A-scan instrumentation and the wide range of application in the diagnosis of intraocular diseases are discussed and representative examples are given to emphasize the clinical significance of this method.

[Cryo-marker for scleral marking of retinal holes (author's transl)]. / Kryo-Markeur zur Skleramarkierung von Netzhautlöchern bei der Ablatio-Operation nach Lincoff.

According to the Lincoff's procedure, a cryoprobe is used for the localization of retinal holes. A cryo-marker developed for Keeler-cryoprobes simplifies the marking of the scleral impression of the cryoprobe, which is often invisible after thawing. The cryo-marker is fixed on the cryoprobe before cryotherapy. During thawing the toothed ring of the cryo-marker is pushed downwards and placed on the sclera. The centre of the ring on the sclera can now be marked by cauterization after the removal of the cryoprobe.

[Fundamentals of echographic diagnosis of acute and chronic sinusitis (author's transl)]. / Grundlagen der echopgraphischen diagnose akuter und chronischer Sinusitiden.

Changes of sound permeability in facial bones are caused by inflammatory or tumorous reaction in the mucosa of the sinuses; echo-orbitography (8-10 MHz) shows in this case extraorbital echo signals if bony walls are thin enough (e.g. Lamina papyracea, anterior and upper wall of the antrum). Further examinations of facial bones show early inflammatory changes of bony tissue in sinusitis without influencing the echographic pattern; the amount of hydroxylapatite remains unchanged.

[Unilateral congenital anophthalmos with Trabecular agenesia and hydrophthalmos of the other eye (author's transl)]. / Einseitiger angeborener Anophthalmus mit Balken-agenesie und Hydrophthalmus am anderen Auge.

In a one-year-old female patient, unilateral anophthalmos was ascertained by clinical, echographic and X-ray examination. In addition, the cranial computer tomogram showed trabecular agenesia. The globe of the other eye was existent and was enlarged by hydrophthalmos. Pediatrically this case represents a syndrome with multiple anomalies of etiologically unknown origin; apart from the ocular malformation there are a severe cerebral developmental disturbance, an apallic syndrome, hypsarrhythmia, peculiar disproportional bodily structure with skeletal anomalies as well as an abnormal susceptibility to infections of the respiratory system and a marked, isolated IgA-deficiency. Neither chromosomal anomaly nor familiarity was discovered.

[Posttraumatic dyslexia without agraphia (author's transl)]. / Posttraumatische Dyslexie ohne Agraphie.

Dyslexia without agraphia is a highly complex cerebral malfunction. A posttraumatic case is considered. The localisation of the lesion is remarkable and leads to the conclusion that associative paths have been largely destroyed.

[Ultrasound diagnosis in seromucinous otitis media (author's transl)]. / Die Ultraschalldiagnostik des Seromukotympanons.

A high frequency ultrasonic in an range from 8-10 MHz is totally reflected from surfaces with boundaries to air as well as from bone surfaces. This principle is utilized, in a fluid filled external acoustical meatus, to diagnose pathological changes in the tympanic cavum. An ultrasonic cannot penetrate a normal cavum tympani; however, if the cavum is entirely full with fluid or tissue matter, then an echographic answer can be obtained of the tympanic membrane and also the paries labyrinthicus of the tympanic cavum. This study examines the clinical possibilities of this non-invasive examination method and points out the various technical difficulties involved. The ultrasonics used in this study are totally harmless to the inner ear.

[Intrabulbar and peribulbar reactive lymphoid hyperplasia]. / Intra-und peribulbäre reaktive lymphoide Hyperplasie.

Report on a 69-year-old woman with a choroidal and a large peribulbar tumor. A scan ultrasonography of the peribulbar mass revealed a homogeneous structure of the lymphoma/sarcoma/pseudo-tumor type. Histological examination disclosed a reactive lymphoid hyperplasia without "Dutcher bodies", and consistent with a benign lymphoma.

[Testing of sound probes for suitability of tissue diagnosis with the help of tissue model (author's transl)]. / Testung von Schallköpfen auf ihre Eignung zur Gewebsdifferenzierung mit Hilfe des Festkörper-Gewebsphantoms.

Echographic tissue diagnosis requires the use of standardized equipment (Echo-Ophthalmograph 7200 MA, Kretztechnik) at a defined system sensitivity, known as tissue sensitivity, with the help of tissue model. Various sound probes were tested; only 8 MHz sound probes (NM 8/5 K) are suitable for tissue differentiation.

[Malignant melanoma of the choroid or metastasis? An echographic differential diagnosis (author's transl)]. / Malignes Melanom oder Aderhautmetastase? Eine echographische Differentialdiagnose.

The echografic criteria for a differential diagnosis between malignant melanoma of the choroid and a metastasis are described. In particular, the reflectivity of these lesions differs, so that malignant melanoma can be diagnosed with a high degree of accuracy, even in cases with primary tumors where a metastasis in the choroid is suspected.