Autologous bone plug-sliding with core decompression and bone marrow aspirate concentrate application: a joint-preserving surgical technique for corticosteroid-induced osteonecrosis of femoral head.

This study aimed to describe a surgical procedure for the management of corticosteroid-induced osteonecrosis of the femoral head (ONFH) and report its clinical results. The technique included harvesting a bone plug from the lateral femoral neck, core decompression, and bone marrow aspirate concentrate (BMAC) application; the procedure was completed by press-fit insertion of the autologous bone plug in the debrided area. Autologous bone plug-sliding with core decompression and bone marrow concentrate aspirate application provides good clinical outcomes in the management of ONFH. A retrospective review was performed using records of patients operated on between October 2019 and June 2021. Only patients with Ficat-Arlet stage-2 ONFH, who underwent the procedure described, were included. Twenty- nine hips (18 patients) were included and evaluated clinically and radiologically. Clinical evaluation included the Harris hip score (HHS) and Visual analogue scale (VAS) for pain, while radiological evaluation included direct radiographs. The average age was 39.8 years (± 11.7, range: 24-65 years). The average follow-up was 13.5 months (± 3.4, range: 8-19 months). There were improvements in the VAS pain and Harris hip scores in all patients. Average HHS increased from 61.90 to 87.45 (p < 0.001), while the average VAS pain score decreased from 7.14 to 3.27 (p < 0.001). No complications were encountered in any of the patients during the follow-up. None of the patients had femoral head collapse on the latest radiograph or required total hip replacement. The combination of the novel autologous bone plug-sliding method with conventional regenerative methods is a successful treatment choice for ONFH.

Lack of association between the methylenetetrahydropholate reductase gene A1298C polymorphism and neural tube defects in a Turkish study group.

The etiology underlying neural tube defects (NTDs) is not fully understood and is believed to involve a complex milieu of genetic and environmental factors. The A1298C polymorphism in the methylenetetrahydropholate reductase gene (MTHFR) has been associated with mild risk for NTDs. In this study, the genotype distribution of the MTHFR gene A1298C polymorphism and the levels of serum homocysteine, vitamin B12, and folate were evaluated in 33 children with NTDs, their mothers, and 46 healthy controls. Genotyping of the A1298C polymorphism was performed by real-time polymerase chain reaction. The A and C allele frequencies in children with NTDs and their mothers were similar to controls (P = 0.160). The 1298AA and 1298CC genotype frequencies (P = 0.551 and 0.062, respectively) in children with NTDs and their mothers did not differ from controls. On the other hand, the 1298AC genotype frequencies in children with NTDs and their mothers were significantly different from controls (P = 0.025). The genotype frequency of 1298AC was lower in children with NTDs than in controls. There was no significant association between clinical distribution of NTDs and 1298AA/AC/CC genotypes (P > 0.05). Serum vitamin B12 levels were higher in children with NTDs than their mothers and controls (P = 0.001). There were no differences among serum homocysteine and folate levels in all groups (P = 0.494 and 0.141, respectively). Both genetic and nutritional factors are important in the etiology of NTDs. Thus, the A1298C polymorphism cannot be regarded as a major risk factor for NTDs.

Serum omentin levels predicts mesenteric ischemia.

BACKGROUND: Acute mesenteric ischemia (AMI) is an intestinal vascular disease with high mortality. Clinical diagnosis of acute mesenteric ischemia is difficult. Adipose tissue is an important mediator of metabolism and inflammation.Omentin is produced by visceral adipose tissue and decreased serum levels of omentin are associated with poor metabolic outcomes. We aimed to investigate whether serum omentin level predicts early diagnosis of AMI before development of transmural ischemia. METHODS: Twenty-four Sprague Dawley rats weighted about 200-250 gr grouped in 3 experimental groups as sham, transient ischemia and permanent ischemia. Each group consisted of 8 rats. Blood samples were evaluated to determine serum urea, creatinine, omentin and C-reactive protein (CRP) levels. A blinded histological examination performed with the same histologist for hemotoxileneosine painted ileal tissue samples. RESULTS: Mean serum omentin level in sham group (27.5±4.67) was significantly elevated compared to rats in Ischemia-reperfusion (IR) group (10.9±9.01).The difference reached the statistical significance (p=0.004). Serum omentin levels were not correlated to urea, creatinine or CRPlevels. CONCLUSION: Omentin levels may be a biochemical indicator to detect AMI. However, further human studies are needed (Tab. 3, Fig. 3, Ref. 34).

Effects of the inflammatory response on serum omentin levels in early acute and chronic pancreatitis.

BACKGROUND AND AIMS: Acute pancreatitis is an acute inflammation of the parenchyma of the pancreas. Several adipokines have been investigated in acute pancreatitis, and these cytokines contribute to inflammation in acute pancreatitis. However, not enough data exist regarding omentin in injuries of the pancreas. Because of a possible common pathogenesis, we aimed to study the association between pancreatic damage and serum omentin levels. MATERIALS AND METHODS: Twenty-four Sprague Dowley rats weighing 200-250 g were randomly placed into three groups: a sham group (n=8), an acute pancreatitis group (n=8), and a chronic pancreatitis group (n=8). Both rats in the sham group underwent laparotomy, and 0.1 cc of saline solution was injected through the pancreatic canal. On the seventh day, a blood sample was obtained by abdominal aorta puncture, and the pancreas was resected for histological examination. In the acute and chronic pancreatitis groups, 0.1 cc of 4.5% Sodium Taurocholote was injected through the pancreatic canal. Blood samples were obtained and pancreatic resection was performed after 24 hours for the acute pancreatitis group and after 7 days for the chronic pancreatitis group. RESULTS: Serum omentin levels of rats with chronic pancreatitis (49.37±2.82 ng/ml) were increased compared to both acute pancreatitis (37.79±1.24 ng/ml) (p<0.01) and sham rats (22.49±1.4 ng/ml) (p<0.01). In addition, the omentin level of rats with acute pancreatitis was significantly increased compared to the sham group (p<0.01). CONCLUSIONS: The elevation in omentin levels in rats in the early stage of pancreatitis was due to the anti-inflammatory effects of omentin; hence, elevated omentin levels improved insulin resistance and caused a significant reduction in glucose levels.

Prevention of torsion-induced testicular injury by Rhodiola rosea.

OBJECTIVE: To evaluate the efficacy of Rhodiola rosea (R. rose) extract in terms of preventing tissue injury induced by testicular torsion and subsequent ischemia/reperfusion (I/R). METHODS: Twenty-one Wistar albino male rats were divided into 3 groups: group 1 = control group, group 2 = I/R group, and group 3 = I/R + extract group. After 2 hours of ischemia and 4 hours of reperfusion, testes were removed and evaluated histologically by hematoxylin and eosin staining. Apoptosis in spermatogonial cells of seminiferous tubules was determined by transferase biotin-2'-deoxyuridine, 5'-triphosphate nick end labeling (TUNEL). To assess oxidative damage, serum malondialdehyde (MDA) and glutathione (GSH) levels were measured. RESULTS: Median MDA and GSH levels were, respectively, 12 ± 3 pmol/mL and 24.8 ± 3.8 µM in group 1, 38 ± 11 pmol/mL and 10.3 ± 1.7 µM in group 2, and 19 ± 5 pmol/mL and 17.6 ± 1.3 µM in group 3 (P <.001 and P <.001, respectively). Median MDA levels, apoptotic cell density, and histopathologic scoring were significantly lower in groups 1 and 3 compared to group 2 (P <.017 for all). Median GSH levels were higher in groups 1 and 3 compared to group 2 (P <.017). CONCLUSION: R. rosea extract was shown to have partially preventive effects on testicular injury induced by torsion in this rat model. The mechanism by which R. rosea extract cause these effects merits further investigation.

Alleviation of kidney damage induced by unilateral ureter obstruction in rats by Rhodiola rosea.

PURPOSE: To evaluate the efficacy of Rhodiola rosea extract in terms of alleviating the renal damage induced by unilateral ureter obstruction (UUO) in rats. MATERIAL AND METHODS: Thirty Wistar albino male rats were divided into five groups: (I) Control, (II) UUO 7 days, (III) UUO 7 days+extract,(IV) UUO 14 days, and (V) UUO 14 days+extract. Seven or 14 days after the initiation of the experimental procedure, the left kidneys of rats in all five groups were removed for histological examination, and their blood was drawn for biochemical measurements. RESULT: Median malondialdehyde (MDA) and glutathione peroxidase (GPx) levels were, respectively, 39.4 (5.04) nmol/mL and 25.8 (8.01) nmol/minute/mL in group I, 77.9 (12.38) nmol/mL and 5.8 (1.95) nmol/minute/mL in group II, 48.7 (12.1) nmol/mL and 9.1 (2.3) nmol/minute/mL in group III, 58.5 (23.83) nmol/mL and 8.4 (2.1) nmol/minute/mL in group IV, and 44.8 (4.97) nmol/mL and 13.8 (3.73) nmol/minute/mL in group V. There was a statistically significant difference among the groups in terms of MDA and GPx levels (p<0.05 for both). The median numbers of apoptotic cells were 1 (1), 8 (2.25), 3 (1.25), 23.5 (9), and 7 (I) in groups I, II, III, IV, and V, respectively. There was a statistically siginificant difference among the groups in terms of apoptotic cell number (p<0.05). CONCLUSION: R. rosea extract was shown to alleviate the renal damage induced by UUO through its antioxidant effects. The mechanism by which R. rosea extract causes these effects merits further investigation.

Characterization of primary and recurrent nodules in liver cirrhosis using contrast-enhanced ultrasound: which vascular criteria should be adopted?

PURPOSE: To assess the impact of different vascular patterns at contrast-enhanced ultrasound (CEUS) on the characterization of small liver nodules (10-30 mm) in cirrhosis and to determine whether primary nodules and recurrent nodules (after a previously treated hepatocellular carcinoma) display variations in enhancement pattern. MATERIALS AND METHODS: A total of 135 cirrhotic patients were evaluated. A diagnosis of hepatocellular carcinoma (HCC) was established according to AASLD Guidelines, based on imaging (computed tomography and/or magnetic resonance) or liver biopsy. All patients underwent CEUS. Different CEUS patterns were evaluated in terms of diagnostic accuracy: HYPER-HYPO: Arterial hyperenhancement followed by washout (hypoechoic appearance compared with surrounding parenchyma) in late phase; HYPER-ISO: Arterial hyperenhancement followed by isoenhancement (isoechoic appearance) in late phase; ISO-ISO: Isoenhancement in all vascular phases. RESULTS: A total of 155 consecutive primary (n = 90) or recurrent (n = 65) nodules were detected. HCC was diagnosed in 127 nodules (71 primary, 56 recurrent). A characteristic HYPER-HYPO CEUS pattern was revealed in 52/127 (40.9%) HCCs (31 primary, 21 recurrent) giving a positive predictive value (PPV) of 98% (97% primary, 100% recurrent) and an accuracy of 51% (54% primary, 46% recurrent). A HYPER-ISO pattern was noted in 46 HCCs (31 primary, 15 recurrent). Assuming this pattern to also be indicative of HCC, the PPV and accuracy were 94% (93% primary, 97% recurrent) and 77% (84% primary, 68% recurrent), respectively. An ISO-ISO pattern was present in 29 HCCs (9 primary, 20 recurrent) and 22 non-HCCs (14 primary, 8 recurrent). CONCLUSION: These data confirm that the HYPER-HYPO pattern at CEUS is definitely diagnostic for HCC in cirrhosis and that the HYPER-ISO pattern has a similar PPV, indicating that this pattern is highly suspicious for HCC. The ISO-ISO pattern was found in > 50% of recurrent nodules and indicates a high risk of HCC.

Protective effect of montelukast, a cysteinyl leukotriene receptor-1 antagonist, against intestinal ischemia-reperfusion injury in the rat.

OBJECTIVE: Ischemia-reperfusion (I-R) injury of the intestine is a significant problem because the initial damage caused by ischemia is exacerbated by reperfusion. In this study, we examined the protective effect of montelukast against I-R-induced intestinal tissue damage. MATERIALS AND METHODS: Eight-week-old male Sprague-Dawley rats were randomly divided into three treatment groups : a sham-operated group, a group receiving I-R, and a group receiving I-R plus montelukast (I-R/M). Tissue samples were evaluated and scored histologically. The blood levels of malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), and cardiotrophin-1 (CT-1) were measured. RESULTS: In the I-R group, the histological score and the levels of serum MDA and MPO were increased compared with those in the control group. In the I-R/M group, the histological score and serum MDA and MPO levels were significantly decreased compared with those in the I-R group. Additionally, compared with the IR group, the I-R/M group had increased serum GSH and CT-1 levels and a decreased intestinal injury score. Ileal sections from the I-R/M group showed minimal alterations, characterized by moderate lifting of the epithelial layer from the lamina propria, and few apoptotic enterocytes were observed compare with the number in the I-R group. CONCLUSION: The findings of the present study demonstrated that montelukast can protect I-R-induced intestinal damage in rats.

Response rate and clinical outcome of HCC after first and repeated cTACE performed "on demand".

BACKGROUND & AIMS: Aim of the study was to assess the clinical impact of conventional transarterial chemoembolization (cTACE) repeated "on demand" on HCC outcome. Outcome measures were: response rate to first and repeated cTACE, recurrence rates and overall survival. METHODS: The outcome of 151 consecutive HCC patients submitted to a first cTACE from January 2004 to December 2005 was retrospectively analyzed. RESULTS: Complete radiological response (CR) was observed in 72/151 (48%), 34/60 (52%) and 12/22 (55%) patients after first, second and third cTACE, respectively. Recurrence rates at 6 and 12months were 37% and 61% after the first cTACE, and 40% and 59% after the second cTACE, respectively. Patients not achieving CR or with a recurrence after CR not treated with curative therapies were 94 and 84 after first and second cTACE, respectively. Of these, 60/94 (64%) and 22/84 (26%) were submitted to a second and third cTACE, respectively. Median overall survival was 32.0months but 25.0months excluding transplanted patients. Factors at the time of first cTACE associated with overall shorter survival at multivariate analysis were higher bilirubin, higher AFP and not achieving CR. CONCLUSIONS: CR and recurrence rates after first and second cTACE were similar. About 64% of patients were submitted to second cTACE, while only few patients (26%) were submitted to third cTACE using an "on demand" policy. These figures may be also useful for planning trials for the evaluation of the efficacy of repeated TACE vs. TACE combined with adjuvant treatments or vs. systemic treatments.

Using high throughput sequencing to explore the biodiversity in oral bacterial communities.

High throughput sequencing of 16S ribosomal RNA gene amplicons is a cost-effective method for characterization of oral bacterial communities. However, before undertaking large-scale studies, it is necessary to understand the technique-associated limitations and intrinsic variability of the oral ecosystem. In this work we evaluated bias in species representation using an in vitro-assembled mock community of oral bacteria. We then characterized the bacterial communities in saliva and buccal mucosa of five healthy subjects to investigate the power of high throughput sequencing in revealing their diversity and biogeography patterns. Mock community analysis showed primer and DNA isolation biases and an overestimation of diversity that was reduced after eliminating singleton operational taxonomic units (OTUs). Sequencing of salivary and mucosal communities found a total of 455 OTUs (0.3% dissimilarity) with only 78 of these present in all subjects. We demonstrate that this variability was partly the result of incomplete richness coverage even at great sequencing depths, and so comparing communities by their structure was more effective than comparisons based solely on membership. With respect to oral biogeography, we found inter-subject variability in community structure was lower than site differences between salivary and mucosal communities within subjects. These differences were evident at very low sequencing depths and were mostly caused by the abundance of Streptococcus mitis and Gemella haemolysans in mucosa. In summary, we present an experimental and data analysis framework that will facilitate design and interpretation of pyrosequencing-based studies. Despite challenges associated with this technique, we demonstrate its power for evaluation of oral diversity and biogeography patterns.

The preventive effect of low molecular weight heparin on CCL4-induced necrosis and apoptosis in rat liver.

INTRODUCTION: Heparin having anti-inflammatory and anti-fibrotic properties may have therapeutic effect on liver injury. The present study investigated the effect of low molecular weight heparin (Enoxaparin) on carbon tetrachloride (CCl4) induced hepatic necrosis and apoptosis in rats. MATERIAL AND METHODS: Thirty male rats were divided into 5 groups. Group I: Control; Group II: Olive oil dissolved CCl4 at dose of 1 mL/kg, ip, twice per week; Group III: CCl4 and Enoxaparin at dose of 180 IU/kg, sc, daily; Group IV: Enoxaparin; Group V: Olive oil at dose of 1 mL, ip, twice per week. The liver histology at the forth week was examined by haematoxylin-eosin, Masson.s trichrome, Toluidine blue and Periodic acid schiff stains. Proliferative and apoptotic activities were assessed semi-quantitatively by proliferating cell nuclear antigen (PCNA) and caspase-3 immune staining and TUNEL method. Semi-quantitative values formulated by the equation HSCORE =ΣP(i) (i+1) including both distribution and intensity of staining. Additionally, nidogen and a-smooth muscle actin were labeled by immunohistochemistry. RESULTS: CCl4 group had marked hepatocelluar necrosis around the vena centralis and increased inflammatory cells and mast cells. Hepatocytes showed deposition of lipid droplets, decrease in glycogen, apoptosis, and picnotic or enlarged nuclei. Enoxaparin reduced necrosis, apoptosis, and number of mast cells but had no effect on lipid droplets in hepatocytes. HSCORE.s of caspase-3 and PCNA were also significantly decreased by administration. CONCLUSION: Enoxaparin have beneficial effects against necrosis as well as apoptosis at the early stage of CCL4 induced liver injury.

A 2008 panorama on osteoporosis and inflammatory bowel disease.

The availability of osteodensitometry has contributed significantly to increase the awareness of inflammatory bowel disease (IBD)-associated bone disease. Reported osteoporosis prevalence in patients with IBD range from 2% to 30%. The fractures risk varies between studies, influenced by demographic, clinical and genetic factors. The main pathogenetic factors involved are malabsorption, treatment with glucocorticoids, inflammation (increased cytokine production) and hypogonadism. A screening should be considered for all patients with small bowel Crohn's disease and especially for those with extensive disease, multiple resections, and malnutrition. Supplementation with both calcium and vitamin D is frequently the first step taken, but is insufficient to inhibit bone loss in many patients requiring use of glucocorticoids. Among available therapies, only biphosphonates are effective for treatment of glucocorticoid-induced osteoporosis.

[Complications after refractive surgery abroad]. / Komplikationen nach refraktiver Chirurgie im Ausland.

BACKGROUND: In this article a retrospective analysis of patients presenting at a German university following refractive surgery abroad is presented. PATIENTS AND METHODS: A total of 20 cases of patients who had undergone treatment between 1998 and 2006 in China (1 case), Greece (1 case), Iran (1 case), Russia (2 cases), Switzerland (1 case), Slovakia (1 case), Spain (2 cases), South Africa (3 cases), Turkey (6 cases) and the USA (2 cases) were analyzed retrospectively. RESULTS: The following complications were observed: epithelial ingrowth into the interface with or without melting of the flap (6 cases), corneal ectasia (2 cases), dislocation of a phakic posterior chamber intraocular lens and prolapse into the anterior chamber with endothelial cell loss (1 case), secondary increase of intraocular pressure following implantation of a phakic intraocular lens (1 case), flap-related complications following laser-in-situ keratomileusis (LASIK) (2 cases), keratitis (1 case), dislocation of the complete flap (1 case), diffuse lamellar keratitis (DLK) grade IV (1 case), hyperopia as a consequence of radial keratotomy (1 case), and under correction/over correction and poor optical quality following laser epithelial keratomileusis (LASEK) and LASIK for high myopia (5 cases) with possible early corneal ectasia. CONCLUSIONS: There are four important problems arising from refractive surgery abroad, often referred to as "LASIK tourism": wrong indications, insufficient management of complications, lack of postoperative care and the health economic aspect.

Treatment of irritable bowel syndrome. A case control experience.

AIM: As optimal therapy for irritable bowel syndrome (IBS) remains elusive, current approach to therapy is based on symptomatic treatment. With this case-control experience we wanted to determine the beneficial effect in IBS patients of a dietary integrator (IBS Active), composed of L-tryptophan, inulin, angelica, vegetal charcoal, vitamin PP, group B vitamins (B1, B2, B6) and probiotics (Lactobacillus sporogenes, Lactobacillus acidophilus, Streptococcus thermophilus). METHODS: The treatment group comprised 37 patients (11 men and 27 women; mean age, 44.3+/-5.1 years) given IBS Active (440 mg bid) over a mean period of 6 months (range, 5-8). The control group comprised 28 patients (6 men and 22 women; mean age, 48.6+/-3.7 years) who were instructed to continue their customary therapy for 6 months (range, 5-7). All subjects were assessed for the presence of abdominal pain and/or distension, constipation, diarrhea and alternating constipation and diarrhea. RESULTS: Compared with baseline values, the reduction in abdominal pain in the treatment group was 62% (P<0.0001), 55% (P<0.0001) in abdominal distension, 58% (P=0.05) in constipation, 33% (P=0.3) in diarrhea, and 62% (P=0.01) in alternation constipation and diarrhea. Compared with baseline values, no statistically significant reduction in symptoms was found in the control group. Post-treatment comparison between the two groups showed that the study product had reduced symptoms and that the difference was statistically significant for abdominal pain (P<0.000001), abdominal distension (P=0.003) and constipation (P=0.03). CONCLUSIONS: The use of IBS Active led to a significant improvement in pain symptoms, abdominal distension and regulation of bowel movement in IBS patients. Further study is needed to evaluate the long-term benefit of the study product.

[Optical quality after refractive corneal surgery]. / Optische Qualität nach refraktiver Hornhautchirurgie.

Correction of myopia, hyperopia and astigmatism within its indicated margin by means of refractive corneal surgical procedures such as LASIK and surface ablation (e.g. PRK) is one of the standard procedures in ophthalmology. Now that advances in the fields of surgical techniques and the technical devices employed have further progressed in terms of safety and predictability, research also focuses on optical quality. "Optical quality" is not a clearly defined parameter, but can be captured indirectly by means of directly measured data. One has to start with the anatomical properties of the eye, which determine the optical images on the retinal level. The quality of the retinal image influences the eye's function, i.e. acuity and contrast perception. Finally, there is the subjective perception of the image we receive. "Optical quality" as such is reflected by the patient's evaluation of this image perception. Three phenomena are especially responsible for deterioration of the quality of the retinal image: diffraction, aberrations and dispersion. Some of the methods for measuring optical quality are subjective questionnaires, functional testing procedures for measuring visual acuity and contrast sensitivity, optical measuring procedures for the determination of optical quality, as well as biomicroscopy, aberrometry and corneal topography for assessing anatomical changes.

[Intraocular lenses for the correction of refraction errors. Part II. Phakic posterior chamber lenses and refractive lens exchange with posterior chamber lens implantation]. / Intraokularlinsen zur Korrektur von Refraktionsfehlern. Teil II: Phake Hinterkammerlinsen und refraktiver Linsenaustausch mit Hinterkammerlinsenimplantation.

In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses which are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for posterior chamber lenses these are mainly cataract formation and pigment dispersion. RLE is preferable in cases of high ametropia in which the natural lens has lost its accommodative effect. The main complications for myopic RLA include retinal detachment, while hyperopic refractive lens exchange may be associated with surgical problems in the narrower anterior eye segment.

[Frankfurt-Freiburg Contrast and Acuity Test System (FF-CATS). A new test to determine contrast sensitivity under variable ambient and glare luminance levels]. / Das "Frankfurt-Freiburg Contrast and Acuity Test System" (FF-CATS). Ein neuer Test zur Kontrastsensitivitätsbestimmung unter variablen Beleuchtungs- und Blendbedingungen.

BACKGROUND: The purpose of the present study was to evaluate a computerized test for measurement of contrast sensitivity thresholds under variable ambient and glare luminance levels. METHODS: A total of 40 eyes of 40 healthy subjects were examined with the FF-CATS and the Functional Acuity Contrast Test (FACT) at 0.167 cd/m(-2) (mesopic) and 167 cd/m(-2) (photopic). Measurements were performed twice with and without glare in a randomized fashion. Tests were evaluated according to three criteria: (1) repeatability, (2) discriminative ability, and (3) validity. RESULTS: The FF-CATS showed a higher discriminative ability between the two groups compared to the FACT charts. Under photopic conditions, the COR value was 0.39 for the FF-CATS and 0.26 for the FACT charts; under mesopic illumination, the COR value for the FF-CATS was 0.46 and 0.36 for the FACT charts. CONCLUSION: The FF-CATS is a reliable, sensitive, valid, and flexible test system for the determination of visual acuity and contrast sensitivity thresholds under variable ambient and glare luminance conditions.

[Higher order aberrations after implantation of an iris claw pIOL (Ophtec Artisan) in the phakic eye]. / Aberrationen höherer Ordnung nach Implantation einer irisgestützten Vorderkammerlinse (Ophtec Artisan) in das phake Auge.

BACKGROUND: The purpose of the present study is to demonstrate the change of higher order wavefront aberrations (HOA) after implantation of an iris claw pIOL. METHODS: Thirteen eyes of seven patients were examined preoperatively and 1 month after implantation of an Artisan lens. The mean preoperative spherical equivalent was -10.69+/-1.92 D (-7.63 to -14.88 D). The diameter of the IOL optic was 6 mm and the lens was inserted though a tunnel incision at 12 o'clock. The root mean square (RMS) wavefront error was computed for all aberrations of the third to fifth order for pupil diameters of 3.5 and 6 mm. RESULTS: On average, HOA RMS changed for a 3.5 mm pupil by 0.037+/-0.089 microm (6 mm pupil: 0.405+/-0.245 microm). Third-order aberrations changed by 0.031+/-0.098 microm (0.320+/-0.269 microm). For both pupil diameters, a notable increase of Z 3,-3 of 0.117+/-0.085 microm (0.596+/-0.350 microm) could be observed depending on the distance between the limbus and incision. Fourth-order aberrations changed on average by 0.018+/-0.037 microm (0.280+/-0.143 microm), namely Z 4,0 increased by 0.025+/-0.034 microm (0.296+/-0.164 microm). CONCLUSION: After implantation of the Artisan lens HOA increased slightly. Particularly induction of Z 3,-3 and Z 4,0 contribute to the increase of HOA. The induction of trefoil ( Z 3,-3) is a result of the incision, whereas the increase of spherical aberration is due to the implant.

Size distribution of trace elements and polycyclic aromatic hydrocarbons in fly ashes generated in Greek lignite-fired power plants.

The fly ashes arrested by the electrostatic precipitators of four large lignite-fired Greek power stations (total installed capacity 4048 MW) were investigated regarding the distribution of 27 major, minor and trace elements and 13 polycyclic aromatic hydrocarbons (PAHs) in six size ranges from <40 to >105 microm. An inverse relationship of concentration with particle size was observed for trace elements, such as As, Se, Zn, Pb, Cd, as well as for Ca, whereas the distribution of the matrix elements Al, Si, Ti, Fe, Mg was fairly flat up to 105 microm with relative enrichment or depletion in larger particle sizes. A reverse relationship of concentration with particle size was also revealed for all PAHs, particularly the heavier compounds. The percent mass of all elements and PAH species in the suspendable fraction (<63 microm) was between 25 and 30%. In all fly ashes, the PAH mixture was dominated by 4-ring species (48-62%) followed by 3-ring compounds (38-41%), whereas the carcinogenic 5- and 6-ring PAHs were less abundant (2-11%). Fly ash PAH concentrations were found to correlate strongly with the concentrations of certain trace elements either positively (e.g. Ba) or negatively (Mg, Cr, V, U) thus suggesting that some lignite elements might promote or prevent PAH formation during combustion. The suspendable fly ash fraction (<63 microm) was found to contain 6-35% of the total mass of individual elements and 10-57% of the total mass of individual PAH components.