Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes.

UNLABELLED: In Hungary, ECG is a keystone of routine athletic screening. Its significance is based on simplicity, quickness and high informative value as well as the fact that appearance of pathological ECG signs can precede the formation of structural heart diseases. During screening of healthy athletes, we studied the incidence of athletic ECG changes and pathological ECG abnormalities. METHODS: We performed detailed analysis of 12-lead ECG recordings of asymptomatic elite, non-elite and master athletes and controls. RESULTS: 227 athletes (male: 180, age: 27.2 ± 8.7 years) and 89 controls (male: 57, age: 28.1 ± 6.8 years) were examined. Benign ECG signs: sinus bradycardia, early repolarization and isolated Voltage criteria of left ventricular hypertrophy were common and more often in athletes compared to controls. Potentially pathological ECG signs: ST- (6.6% vs. 1.1%, p < 0.05) and T-wave (15.0% vs. 5.6%, p < 0.05) changes and signs of pathological left ventricular hypertrophy (5.3% vs. 0%, p < 0.05) occurred more frequently in athletes compared to controls. CONCLUSIONS: Signs of pathological left ventricular hypertrophy and repolarization abnormalities are more often in athletes. No structural heart disease could be verified in the background of the disorders. However, athletes having pathological ECG should be kept under tight cardiology control. Exact definition and widespread knowledge of pathological ECG changes is essential in early recognition of high risk athletes.

Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma.

PURPOSE: To evaluate the diagnostic accuracy of retinal nerve fibre layer thickness (RNFLT), ganglion cell complex (GCC), and optic disc measurements made with the RTVue-100 Fourier-domain optical coherence tomography (OCT) to detect glaucoma in a Caucasian referral population. METHODS: One randomly selected eye of 286 Caucasian patients (93 healthy, 36 ocular hypertensive, 46 preperimetric glaucoma, and 111 perimetric glaucoma eyes) was evaluated. RESULTS: Using the software-provided classification, for the total population sensitivity did not exceed 73.6% for the optic nerve head parameters, and 62.7% for the other parameters. Specificity was high (94.6-100%) for most RNFLT and GCC parameters, but low (72.0-76.3%) for the optic disc parameters. Positive predictive value varied between 98.1 and 100% for the main RNFLT parameters, 92.6 and 100% for the 16 RNFLT sectors, 92.4 and 99.0% for the GCC parameters, but did not exceed 86.3% for any of the optic disc parameters. Positive likelihood ratio (PLR) was higher than 10 for average, inferior and superior RNFLT (25.5 to infinite), 12 of the 16 RNFLT sectors (12.6 to infinite), and three of the four GCC parameters (40.0 to 48.6). No optic disc parameter had a PLR higher than 3.0. CONCLUSIONS: RNFLT and GCC parameters of the RTVue-100 Fourier-domain OCT showed moderate sensitive but high specificity, positive predictive value and PLR for detection of glaucoma. The optic disc parameters had lower diagnostic accuracy than the RNFLT and GCC parameters.

Health anxiety in a non-population-based, pre-publicised glaucoma screening exercise.

OBJECTIVE: To investigate whether anxiety plays a role in self-recruitment for non-population-based glaucoma screening. METHODS: In a non-population-based pre-publicised trial, self-recruited Caucasian participants were screened for glaucoma, and also completed the Trait Anxiety Inventory and Shortened Health Anxiety Inventory questionnaires. In pre-publicity for the trial, information on risk factors for glaucoma was given. Participants classified as possible glaucoma cases later underwent a detailed glaucoma investigation. RESULTS: Of the 120 total participants (72 females, 48 males), 12 were considered glaucoma suspects at the screening, although only three (2.5%) were ultimately diagnosed with glaucoma. Health anxiety showed significant correlation with trait anxiety (r=0.525, P<0.001). Trait anxiety was similar for both the genders; this score was significantly below the normal Hungarian population value in women (P<0.001) and at the normal population level in men (P=0.560). In contrast, health anxiety was significantly higher than for both the 'normal' and 'anxious' reference groups (P<0.001), although smaller than that for hypochondriacs (P<0.001). Participants with pre-existing ocular symptoms, and those who attended because of fear of blindness, had significantly higher trait- and health-anxiety scores (P<0.05 for all comparisons). CONCLUSION: In this screening trial, the health anxiety of the self-recruited participants was significantly above normal, whereas the prevalence of glaucoma was within the usual range for a Caucasian population. This suggests that providing pre-publicity information on risk factors for glaucoma does not necessarily increase the prevalence of glaucoma among self-recruited participants in non-population-based screening, as some individuals may participate on account of elevated health anxiety, rather than because of higher potential risk for glaucoma.

Relationship between autonomic neuropathy and hypertension--are we underestimating the problem?

BACKGROUND: Cardiac autonomic neuropathy (CAN) is associated with significant morbidity and mortality in diabetes and the risk is even greater in those with hypertension. AIMS: The aim of our study was to investigate the relationship between CAN and 24-h blood pressure profile in normoalbuminuric patients with Type 2 diabetes mellitus. METHODS: Seventy patients with Type 2 diabetes (31 without CAN, 39 with CAN), who had no history of hypertension, and 29 healthy volunteers underwent five standard cardiovascular reflex tests to assess autonomic function and 24-h ambulatory blood pressure monitoring. RESULTS: Twenty-four-hour mean systolic blood pressure, blood pressure load and hyperbaric impact values were significantly higher in diabetic patients with CAN compared with control subjects and diabetic patients without CAN (P < 0.05). In spite of normal clinic blood pressures, 54% of diabetic subjects with CAN and 29% without CAN were hypertensive (systolic blood pressure load > 20%, P < 0.05). In the diabetes group as a whole, Valsalva ratio, postural systolic blood pressure changes and diastolic blood pressure responses during sustained handgrip correlated significantly and negatively with 24-h mean systolic blood pressure (P < 0.01, P < 0.001, P < 0.05) and blood pressure load (P < 0.05, P < 0.001, P < 0.05). CONCLUSIONS: Cardiovascular autonomic neuropathy is independently associated with hypertension in normoalbuminuric Type 2 diabetic patients with no history of hypertension. Relying on clinic blood pressures in subjects with CAN could lead to a failure to diagnose hypertension in over half of cases. All normotensive patients with CAN should be screened for hypertension using ambulatory blood pressure monitoring in order to institute early aggressive interventions to improve their long-term outlook.

Correlation between polarimetric retinal nerve fiber layer thickness and retinal sensitivity determined with frequency-doubling technology.

BACKGROUND AND OBJECTIVE: Correlation between polarimetric retinal nerve fiber layer thickness measured with variable corneal compensation and retinal sensitivity measured with frequency-doubling technology (FDT) and standard automated perimetry (SAP) was investigated. PATIENTS AND METHODS: Twenty-four consecutive patients with chronic open-angle glaucoma and 17 healthy control subjects (1 randomly selected eye for each subject) were evaluated. RESULTS: For all subjects, quadrant scanning laser polarimetry parameters correlated positively with both FDT and SAP mean sensitivity of the opposite hemifield (P< .001). Global scanning laser polarimetry parameters correlated positively with FDT-mean sensitivity, SAP-mean sensitivity, and FDT-mean deviation, and negatively with SAP-mean deviation (in SAP, mean deviation is positive in case of sensitivity loss) (P < or = .02). The nerve fiber indicator also correlated with FDT-pattern standard deviation and SAP-corrected loss variance (P < or = .01). Using un-logged sensitivity values, no further correlations were found. CONCLUSION: Our results show that a similar structure-function relationship exists between polarimetric retinal nerve fiber layer thickness determined with variable corneal compensation and retinal sensitivity measured with SAP and FDT.

A case-control study of congenital abnormality and dimenhydrinate usage during pregnancy.

OBJECTIVE: The objective was to determine the teratogenicity of dimenhydrinate, an anti-emetic drug. METHODS: We compared patients with congenital abnormalities with matched normal controls. Cases were taken from the population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996, while matched controls were from the National Birth Registry of the Central Statistical Office. RESULTS: Out of 38,151 newborn infants with no congenital abnormalities (control group), 1,726 (4.5%) were treated with dimenhydrinate during pregnancy, while out of 22,843 cases with congenital abnormalities, the number was 914 (4.0%; unadjusted prevalence odds ratio with 95% confidence interval: 0.9, 0.8-1.0). There was thus no indication of teratogenicity with dimenhydrinate. However, a lower rate of obstructive uropathy was found in infants born to mothers treated with dimenhydrinate during the first trimester of pregnancy than in infants whose mothers did not take the drug at that time.

Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis.

AIMS: To determine the efficacy and safety of 600 mg of alpha-lipoic acid given intravenously over 3 weeks in diabetic patients with symptomatic polyneuropathy. METHODS: We searched the database of VIATRIS GmbH, Frankfurt, Germany, for clinical trials of alpha-lipoic acid according to the following prerequisites: randomized, double-masked, placebo-controlled, parallel-group trial using alpha-lipoic acid infusions of 600 mg i.v. per day for 3 weeks, except for weekends, in diabetic patients with positive sensory symptoms of polyneuropathy which were scored by the Total Symptom Score (TSS) in the feet on a daily basis. Four trials (ALADIN I, ALADIN III, SYDNEY, NATHAN II) comprised n=1258 patients (alpha-lipoic acid n=716; placebo n=542) met these eligibility criteria and were included in a meta-analysis based on the intention-to-treat principle. Primary analysis involved a comparison of the differences in TSS from baseline to the end of i.v. Treatment between the groups treated with alpha-lipoic acid or placebo. Secondary analyses included daily changes in TSS, responder rates (> or =50% improvement in TSS), individual TSS components, Neuropathy Impairment Score (NIS), NIS of the lower limbs (NIS-LL), individual NIS-LL components, and the rates of adverse events. RESULTS: After 3 weeks the relative difference in favour of alpha-lipoic acid vs. placebo was 24.1% (13.5, 33.4) (geometric mean with 95% confidence interval) for TSS and 16.0% (5.7, 25.2) for NIS-LL. The responder rates were 52.7% in patients treated with alpha-lipoic acid and 36.9% in those on placebo (P<0.05). On a daily basis there was a continuous increase in the magnitude of TSS improvement in favour of alpha-lipoic acid vs. placebo which was noted first after 8 days of treatment. Among the individual components of the TSS, pain, burning, and numbness decreased in favour of alpha-lipoic acid compared with placebo, while among the NIS-LL components pin-prick and touch-pressure sensation as well as ankle reflexes were improved in favour of alpha-lipoic acid after 3 weeks. The rates of adverse events did not differ between the groups. CONCLUSIONS: The results of this meta-analysis provide evidence that treatment with alpha-lipoic acid (600 mg/day i.v.) over 3 weeks is safe and significantly improves both positive neuropathic symptoms and neuropathic deficits to a clinically meaningful degree in diabetic patients with symptomatic polyneuropathy.

Validation studies of drug exposures in pregnant women.

The aim of these studies was to check the quality of data collection concerning drug use during pregnancy in the Hungarian Case-Control Surveillance of Congenital Abnormalities from four different aspects. (a) The parents of non-respondent cases were visited at home to collect data, but the Ethics Committee did not allow collection of comparable data from non-respondent control women. Thus only 200 selected non-respondent controls were visited at home and questioned about drug use as part of a validation study. There was no difference in the distribution and occurrence of frequently used drugs between the respondent and non-respondent control groups. (b) Data collection was compared between the usual method of the Case-Control Surveillance and personal interview in case with congenital limb deficiencies. In general, the two methods produced similar results with respect to drug use, but the personal interview revealed a higher use of unintended contraceptive pills while the use of antenatal care logbooks in the Case-Control Surveillance showed a higher use of drugs to prevent threatened abortion and preterm delivery. (c) A check of source and completeness of drug exposure showed that about one-quarter of the drugs used during pregnancy were not recorded in the Case-Control Surveillance, and the proportion of lack of recall was about 23%. A small group of women (2.4%) did not use prescribed drugs due to the suspected teratogenic risk. (d) The teratogenic labelling of drugs deters pregnant patients from the use of prescribed drugs, or at least shortens the duration of drug intake. Thus the evaluation of drug use on the basis of medically recorded prescribed drugs and/or usual recommendations produces a bias thus it is necessary to complete it with information from the patients.

Case-control study of teratogenic potential of thiethylperazine, an anti-emetic drug.

OBJECTIVE: Thiethylperazine is a commonly used anti-emetic drug during pregnancy in Hungary. One experimental study in mice and rats found an increased occurrence of cleft palate after the use of thiethylperazine during pregnancy but the human data of thiethylperazine have not been reported. Thus, the aim of the study was to investigate the possible human teratogenic effect of thiethylperazine. DESIGN: Case-control approach. SETTING: The teratogenic potential of thiethylperazine was evaluated in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. SAMPLE: Of 38,151 newborn infants without any congenital abnormalities (control group), 746 (2.0%) had mothers who were treated with thiethylperazine, while of 22,843 cases with congenital abnormalities, 411 (1.8%) had mothers who were treated with thiethylperazine during pregnancy. METHODS: Case-control pair analysis. MAIN OUTCOME MEASURES: Different congenital abnormalities. RESULTS: The pairs of cases with congenital abnormalities and their matched controls without congenital abnormalities were compared and this approach showed a somewhat higher rate of cleft lip +/- palate (OR: 2.0 with 95% CI: 1.0-4.0) in infants born to mothers with thiethylperazine treatment during the first trimester of pregnancy. CONCLUSION: Our data do not indicate clear teratogenic effect of thiethylperazine, however, a weak association was found between thiethylperazine use and cleft lip +/- palate.

Influence of post-LASIK corneal healing on scanning laser polarimetric measurement of the retinal nerve fibre layer thickness.

AIM: To investigate the influence of laser assisted in situ keratomileusis (LASIK) on the values for retinal nerve fibre layer thickness (RNFLT) as measured with scanning laser polarimetry (SLP) during the healing process of the cornea after LASIK. METHODS: SLP with the GDx instrument was performed on 20 consecutive healthy subjects without any eye disease undergoing LASIK for ametropia correction. The SLP measurements were performed before the surgery, and at 1 and 3 days, as well as at 3 months, after LASIK. Thickness data from images of one randomly selected eye per subject were analysed using the ANOVA and Duncan multiple comparison tests. Correlation coefficients between RNFLT data and the treatment parameters were also calculated. RESULTS: Somewhat similar results were found for the different retinal areas. The measured values for superior average RNFLT decreased significantly at all time points compared to the preoperative baseline (p<0.003, Duncan test), but increased significantly between postoperative day 1 and the final visit at 3 months (p=0.025, Duncan test). Inferior average RNFLT in the early postoperative days was significantly smaller than at 3 months after LASIK (p<0.05, Duncan test), and tended to be smaller than at baseline. The thickness values before surgery and at the final visit, however, showed no significant difference (p=0.698, Duncan test) in this region. Ellipse average RNFLT was significantly smaller in the early postoperative days than the baseline value before LASIK. However, the measured value had significantly increased again by the time of the final visit (p<0.02, Duncan test). This value at the final visit showed no difference from the baseline value (p=0.46, Duncan test). The changes in the nasal average and temporal average RNFLT were not statistically significant. No correlation was found between the change in the SLP measured thickness values and central corneal thickness at baseline and its change after surgery, nor with the change in cylindrical correction due to LASIK, or the length of the suction time during surgery (p>0.05 for all correlations). CONCLUSION: The SLP technique is sensitive to the corneal optical properties, and RNFLT as measured with SLP shows changes after LASIK. Most of these changes, however, diminish with time after surgery, and the values tend to return to the preoperative results during the first 3 months of corneal healing following uncomplicated LASIK. It appears that in uncomplicated cases the transient RNFLT changes are artefacts and do not imply pathological thickness alterations due to LASIK.

Scanning laser polarimetry versus frequency-doubling perimetry and conventional threshold perimetry: changes during a 12-month follow-up in preperimetric glaucoma. A pilot study.

PURPOSE: To evaluate the possibility for detecting the progression in preperimetric primary open angle glaucoma (POAG) using scanning laser polarimetry (SLP), frequency-doubling technology (FDT), and conventional automated perimetry (AP). PATIENTS AND METHODS: 22 eyes of 11 preperimetric POAG patients were evaluated using SLP (Nerve Fiber Analyzer, GDx), AP (Humphrey 24-2 threshold test) and FDT (30 degrees threshold test). All eyes had intraocular pressure (IOP) higher than 21 mmHg before treatment, but were consistently lower than 22 mm Hg with unchanged topical medication before and during the study. At the initial evaluation session optic nerve heads showed mild glaucomatous changes but the visual fields were normal (MD better than 2.0 dB, Glaucoma Hemifield Test: within normal limits or borderline). AP and FDT measurements were repeated 6 months later, and all three tests were repeated 12 months after the first investigation. RESULTS: IOP, AP and FDT measurements showed no statistically significant changes during the 12-month follow up period. In contrast to this, a tendency for a glaucomatous type decrease was seen with SLP in the retinal nerve fibre layer (RNFL) thickness parameters (mean superior and inferior sector thickness values, ellipse average thickness and maximal modulation). The mean decrease of RNFL thickness in the superior and inferior sectors was 2.77 microm and 2.48 microm, respectively. Using the two-way nested ANOVA, which considers the relation between the right and left eyes of the subjects, the decrease was statistically significant (p=0.021) for the inferior sector RNFL thickness. CONCLUSION: The results suggest that scanning laser polarimetry is a useful technique to detect and measure glaucomatous progression in early glaucoma. Scanning laser polarimetry of the RNFL may help to detect and quantify early progression even if worsening is not seen with perimetry and FDT tests.

[The role of estrogen receptor, vitamin D receptor and calcium receptor genotypes in the pathogenesis of colorectal cancer]. / Osztrogén-, D-vitamin- és kalcium-érzékeló receptorok genotípusainak szerepe a colorectalis daganatok patogenezisében.

In this study, the Xbal polymorphisms of the estrogen-, the Bsml polymorphism of the vitamin D- as well as the A986S polymorphism of the calcium-sensing receptor genes were investigated in 56 patients with colorectal cancer. The expression of erbB-2, epidermal growth factor receptor, ras, p53 and their relationship to estrogen-, vitamin D- and calcium-sensing receptor genotypes were also studied. In subjects exhibiting XX genotype of the estrogen receptor gene or bb genotype of the vitamin D receptor gene, erbB-2 expression was significantly lower compared to those with xx, Xx or BB, Bb (6/56 and 11/56 vs. 31/56 and 26/56; p = 0.0043 and 0.041). The presence of the XX alleles of estrogen receptor gene significantly correlated with the overexpression of the epidermal growth factor receptor expression in tumors, whereas in xx and Xx genotypes, significantly higher expression was seen (7/56 vs. 30/56; p = 0.049). Analyzing the combinations of the two gene allelic variants, we have found XXbb genotype to be associated with a significantly lower erbB-2 expression, compared to other combinations (Xxbb, XxBb, XXBb) (2/7 vs. 7/7, 4/5, 4/5; p = 0.0011). Patients with AA calcium-sensing receptor genotype were in higher UICC stages at the time of discovery of their disease than those with AS genotype. The AA allelic variant of the calcium-sensing gene was more frequent among patients with colorectal cancer compared to controls (36/56 vs. 36/112; p = 0.0004). Our observations raise the possibility that estrogen-, and vitamin D receptor gene polymorphisms accompanied with variable oncogene expression might influence the pathogenic processes resulting in the development of colorectal cancer. The A986S polymorphism of calcium-sensing receptor might also be a prognostic marker of the disease.

Ocuton-S self tonometry vs. Goldmann tonometry; a diurnal comparison study.

PURPOSE: To compare 24-hour diurnal intraocular pressure (IOP) measurements obtained using the Ocuton-S applanation self tonometer and the Goldmann tonometer. METHODS: 24-hour diurnal IOP curves were obtained on 14 eyes of 7 trained patients suffering from medically controlled primary open angle glaucoma. IOP was measured every third hour starting at 9 a.m. with a calibrated Goldmann tonometer; one week later, a similar set of measurements was obtained with Ocuton-S self tonometry by the patients. One week later still, ultrasound corneal pachymetry was performed at the same hours. RESULTS: Overall IOP (24-hour mean) did not differ significantly between the different measuring techniques (ANOVA, p = 0.74), but the IOP differed in a statistically significant manner around the clock (ANOVA, p = 0.00006). The mean Goldmann tonometric readings were up to 2.8 mmHg lower than the Ocuton-S values during the daytime (9 a.m. to 9 p.m.), however, during the night (12 midnight to 6 a.m.) mean IOP measured with Goldmann tonometry was 2.2 to 3.3 mmHg higher than the corresponding average of the self tonometry readings. There was a statistically significant interaction between the type of tonometry and the time of the measurement (p = 0.0007). Central corneal thickness (CCT) showed a significant change during the 24-hour period (p = 0.000001). CONCLUSION: IOP shows a different diurnal curve when measured with the Goldmann tonometer and with the Ocuton-S applanation self tonometer. The instruments' readings might be influenced in different ways by the diurnal changes of the corneal thickness. Since Ocuton-S self tonometry underestimates the IOP in the early morning period, a careful evaluation is necessary when nocturnal and early morning IOP elevation is investigated with this technique.

Vitamin D and estrogen receptor gene polymorphisms in type 2 diabetes mellitus and in android type obesity.

OBJECTIVE: We studied the significance of BsmI restriction enzyme polymorphism of the vitamin D receptor (VDR) gene and the XbaI and PvuII polymorphisms of the estrogen receptor (ER) gene in patients with type 2 diabetes (n=49), android type obesity with normal carbohydrate metabolism (n=29) and healthy controls (n=138). METHODS: The distribution of genotypes in the study groups, as well as their relationship to fasting and 1 h postprandial serum C-peptide levels were analyzed. RESULTS: Postprandial serum C-peptide levels of BB genotypes were significantly higher in the diabetes and obese groups (6.18+/-5.09 ng/ml) compared with other genotypes (2.71+/-2.45 vs. 1.72+/-1.97 ng/ml, respectively, P=0.05). Among patients with type 2 diabetes and obese subjects, the XX allelic variant of the ER gene was more frequent (P=0.00015). Postprandial C-peptide levels of subjects exhibiting XX genotype were significantly lower compared with those with Xx genotype (1.67+/-2.16 vs. 3.8+/-3.72 ng/ml, P=0.021). The BBXx allelic combination of the VDR/ER receptor genes was less frequent in diabetic patients than in healthy subjects or in obese patients. The BBXx genotype was associated with significantly elevated postprandial C-peptide levels in all subjects compared with other combinations (9.65+/-3.14 vs. 1.35+/-2.82 ng/ml, P=0.003). No difference was found in the distribution of the PvuII polymorphism of the ER gene or in the association with the C-peptide levels among study groups. CONCLUSION: Polymorphisms of the VDR/ER receptor genes might play a role in the pathogenesis of type 2 diabetes by influencing the secretory capacity of beta-cells.

Lack of association between interleukin-1 receptor antagonist protein gene polymorphism and bone mineral density in Hungarian postmenopausal women.

The major determinant for risk of osteoporosis in later life is bone mineral density (BMD) attained during early adulthood. Bone mineral density is a complex trait that is presumably influenced by multiple genes. Interleukin-1 receptor antagonist protein (IL-1RN) is an attractive candidate gene for osteoporosis susceptibility, because IL-1RN completely inhibits the stimulatory effects of interleukin-1 (IL-1) on bone resorption in organ cultures and has been implicated in the pathogenesis of osteoporosis. In addition, the IL-1RN gene contains a variable-number tandem repeat polymorphism (VNTR) in intron 2 with three potential protein-binding sites. Recently, an association has been found between this polymorphism and postmenopausal bone loss in the spine. In this study, we use the previously described IL-1RN polymorphism to test for an association between this polymorphism and bone mineral density in our population of postmenopausal women. There was no correlation between alleles or genotypes and BMD in the 286 subjects. Dividing subjects into osteoporotic and healthy groups (osteoporotics and controls), we found no difference in the distribution of alleles or genotypes between groups. We found no association between IL-1RN alleles or genotypes and BMD either at the lumbar spine or the femoral neck within groups. Our data do not support the hypothesis that this IL-1RN gene VNTR polymorphism has an impact on bone mass in postmenopausal women.

Immediate increase in aqueous humour endothelin 1 concentration and intra-ocular pressure after argon laser trabeculoplasty in the rabbit.

PURPOSE: To investigate the immediate changes of aqueous humour endothelin 1 (ET-1) concentration and intra-ocular pressure (IOP) after argon laser trabeculoplasty (ALT) in the rabbit. METHODS: Standard ALT was performed in one eye of 11 pigmented rabbits. IOP was measured with a Tono-Pen-2 tonometer before treatment, under general anaesthesia. Postlaser IOP measurements followed by aqueous humour aspiration were performed under general anaesthesia 30 and 60 min after treatment in 6 and in 5 animals, respectively. RESULTS: The aqueous humour ET-1 concentration was significantly higher (55.0 pg/ml) after ALT than in the contralateral eyes without laser treatment (8.2 pg/ml, p = 0.001). IOP increased significantly after ALT (p = 0.007) but remained unaltered (p = 0.10) in the contralateral eyes without treatment. No statistically significant difference was found either in postlaser IOP elevation or in interocular ET-1 difference between the groups. CONCLUSIONS: The results suggest that in the rabbit the increase in aqueous humour ET-1 concentration after ALT is immediate, detectable even 30 min after the laser treatment, followed by no further increase during the second 30-min period after ALT, and associated with an immediate postlaser IOP elevation within 1 h after ALT. These findings may suggest a similar response to ALT in the human eye, since a similar immediate IOP elevation is frequently observed after ALT in the clinical practice.

Vitamin D receptor gene BsmI polymorphism correlates with erbB-2/HER-2 expression in human rectal cancer.

Apart from the regulation of calcium metabolism, 1, 25-dihydroxyvitamin D(3) plays an essential role in cell proliferation and differentiation in several tissues. The vitamin D receptor (VDR) gene shows polymorphisms in humans that appear to be clinically significant in some pathological conditions. In the present study, the BsmI polymorphism of the VDR gene was studied in 59 Caucasian patients with rectal cancer (mean follow-up: 48 months). The relationship between VDR genotypes and the expression of oncogenes as well as their influence on survival were also investigated. VDR polymorphism was examined in tumor and normal mucosa cells by PCR technique. The expression of erbB-2/HER-2, p53, ras and epidermal growth factor receptor (EGFR) was also detected by immunohistochemistry and protein blotting. The presence of the VDR B allele significantly correlated with the overexpression of the erbB-2 oncogene. There was no difference in the VDR genotype between cancer and normal mucosal cells. Coexpression of erbB-2, pan-ras, p53 and EGFR internal and external domains was significantly higher in cancer cells than in normal mucosa. There was no significant correlation between VDR genotypes and age, gender, tumor infiltration depth, number and site of lymph node metastases and lymphatic or blood vessel infiltration. The VDR genotype alone did not influence survival. Overexpression of erbB-2 and EGFR was associated with a poor prognosis. In patients expressing only one oncogene in cancer cells, the presence of the VDR B allele showed a tendency to a poor prognosis. In conclusion, VDR gene BsmI polymorphism might affect the development and prognosis of rectal cancer by influencing erbB-2 oncogene expression.