Non-lethal infection of aminergic reticular core neurons: age-dependent spread of ts mutant vesicular stomatitis virus from the nose.

In order to induce a non-lethal infection restricted to central aminergic neurons projecting to the olfactory bulbs a series of temperature sensitive (ts) and G-protein monoclonal antibody escape mutants of vesicular stomatitis virus (VSV) were instilled into the nasal cavity of mice. In three-week (wk)-old NMRI mice four monoclonal antibody escape mutants caused an extensive infection of the olfactory epithelium and, like a wild type strain, a lethal brain infection after spread along olfactory pathways. Three ts mutant strains showed an attenuated pathogenic potential. Strain G31 caused a lethal infection with a somewhat prolonged course while the strain G11 failed to invade the nervous system. Strain G41 showed minimal invasion of central nervous system in three-wk-old mice and caused a lethal infection in newborn and one-wk-old mice. In contrast, two-wk-old mice survived infection with this mutant, which spread along olfactory pathways and rather selectively affected aminergic reticular core neurons in the diagonal band, the locus ceruleus and the raphe nuclei in the brainstem. Thus, an age-dependent virus infection of the olfactory pathways can cause restricted lesions in the brain providing a model for studies of virus-induced changes in aminergic neurotransmission.

Long-term efficacy and safety of simvastatin alone and in combination therapy in treatment of hypercholesterolaemia.

The 3-years efficacy and safety of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor simvastatin (S) (previously called synvinolin or MK-733) has been studied in single and combined therapy with cholestyramine (C) in 48 hypercholesterolaemic patients. Plasma lipids, lipoproteins and apolipoproteins A-I and B, and blood safety tests (haematology, liver function, creatine phosphokinase (CPK), creatinine, blood glucose and thyroid function) were determined regularly throughout the study. Extensive ophthalmological examinations with particular focus on the lens were done before initiation of therapy and at every 6 months during drug treatment. Maximal reductions of mean plasma total cholesterol concentration (34% with S; 47% with S + C) and low-density lipoprotein (LDL)-cholesterol concentration (42% with S; 56% with S + C) were achieved after 4 weeks on full-dose therapy. During continued treatment, years 1 through 3, the reduction of mean plasma total cholesterol was 26-29% with S alone, and 31-41% with S + C. Significant reductions of plasma triglycerides (15-27%) and very low density lipoprotein (VLDL) triglycerides (10-27%) were achieved in the group treated with S as single therapy. In this group there was also a significant increase (10-14%) of high-density lipoprotein (HDL)-cholesterol. In liver aspartate (AST) and alanine (ALT) aminotransferases, as well as alkaline phosphatase (ALP), minor and variable, but usually transient, increases were seen. Repeated ophthalmological examinations did not demonstrate any drug-related side effects. It is concluded that simvastatin is a safe and efficient cholesterol-lowering drug for long-term therapy, both as a single drug and in combination with cholestyramine.

Superoxide dismutase in the anterior chamber and the vitreous of diabetic patients.

Total superoxide dismutase (SOD) activity was examined in the anterior humor of 32 diabetic patients and 34 nondiabetic controls during cataract extraction. Median age (95% confidence interval) was 77.5 yr (73.3-81.0) and 79.3 yr (76.0-83.2), respectively. The SOD activity also was examined in posterior vitreous sampled peroperatively in 10 diabetics with proliferative retinopathy and post-mortem in seven diabetic patients and 35 nondiabetic controls. Ages were 57.2 yr (35.0-73.9), 74.4 yr (40.7-83.6), and 73.8 yr (65.0-80.2), respectively. In nondiabetic patients, the total SOD activity was much lower in the anterior chamber, 9.9 U/ml (8.1-12.6), than in the posterior vitreous, 106.3 U/ml (range 65.6-119.0), P < 0.001. We found no difference between the SOD levels in the anterior chamber of nondiabetic controls and diabetic patients, who had 9.6 U/ml (7.6-13.7). The SOD activity in posterior vitreous in diabetic patients sampled peroperatively, 23.9 U/ml (8.9-39.2), P < 0.0001, and post-mortem, 39.5 U/ml (6.5-214.2), P < 0.04, was significantly lower than in the controls sampled post-mortem, 106.3 U/ml (65.6-119.0). Low levels of SOD in the anterior chamber may be involved in cataract development, in diabetic patients and nondiabetic controls. That diabetics had decreased SOD activity in the posterior vitreous points to a possible role of SOD in the complex process of diabetic retinopathy development.

Carbon monoxide blood levels and reported cessation of smoking.

The carboxyhemoglobin (COHb) level was estimated in patients attending an anti-smoking clinic. A surprisingly large fraction of patients that reported "no smoking" were found to have abnormally high COHb. We believe that this discrepancy is due to the patients not reporting their smoking habits correctly. This phenomenon is further evidence that smoking should be regarded as a form of drug addiction in some persons. Some early relapses in stop-smoking programs can apparently be explained by the patient's admitting previously concealed smoking. For scientific purposes the results of stop-smoking cures should be evaluated by other means than the patient's own reports.

Bilateral same day phacoemulsification: 220 cases retrospectively reviewed.

BACKGROUND/AIMS: The relative frequency, basic patient data, results, and complications of planned same day bilateral phacoemulsification were studied from April 1999 to May 2001 at the Department of Ophthalmology, Linköping University Hospital, Sweden. METHODS: Retrospective study of patient records (n=220) regarding preoperative and postoperative visual acuity, applied indications, concurrent disease, preoperative, peroperative, and postoperative complications, and number of unplanned postoperative visits. The monthly rate of bilateral phacoemulsification to all cataract procedures was monitored. RESULTS: Mean corrected preoperative visual acuity was 0.27 (worse eye) and 0.39 (better eye), and postoperatively (all eyes) 0.71. Visual acuity was 0.5 or better in 78% of eyes. Preoperative considerations included type of cataract, to avoid anisometropia, social circumstances, and concurrent eye disease. Reasons for unplanned postoperative visits included secondary cataract (n=10), iritis (n=6), corneal oedema (n=3), cortex in the anterior chamber (n=2), and unilateral endophthalmitis (n=2). During the study period, 10.5% of patients were operated upon bilaterally on the same day. CONCLUSIONS: Same day bilateral phacoemulsification was found to be a safe and cost effective way of rapidly rehabilitating selected cataract patients. The patient must be informed of the added potential risks as well as the benefits of the procedure.

Cataract surgery and quality of life in patients with age related macular degeneration.

BACKGROUND: The coexistence of cataract and age related macular degeneration (AMD) is not unusual, especially in the very elderly. The outcome of cataract surgery in these cases depends on the effect of AMD on vision. In this study the authors have compared the outcome of cataract patients with AMD to that of cataract patients with no vision threatening ocular comorbidity, and analysed possible predictors of good or poor outcome. METHODS: An observational prospective study on consecutive cases operated for cataract during 1 month at six surgical departments affiliated to the Swedish National Cataract Register (NCR). Data were collected according to the protocol of NCR and subjects completed the Catquest questionnaire before and 6 months after surgery. 90 subjects with AMD were compared to 335 subjects with no sight threatening ocular comorbidity. RESULTS: Difficulties in performing various daily life activities improved significantly for AMD subjects after surgery (p<0.001, Wilcoxon signed rank test). Satisfaction with vision also improved significantly after surgery (p<0.001, Wilcoxon signed rank test). Activity level and independence were unchanged. Subjects with no ocular comorbidity had a still better outcome. The most important variable related to a good self assessed functional outcome was postoperative visual acuity irrespective of the presence of AMD. AMD subjects scheduled for second eye surgery and AMD subjects dissatisfied with their vision before surgery had a poorer outcome. CONCLUSION: Subjects with various stages of dry AMD and cataract improved their self assessed visual function and satisfaction with vision significantly after cataract extraction.

Atelectasis causes gas exchange impairment in the anaesthetised horse.

The anatomical basis of gas exchange impairment in the anaesthetised horse was studied by computerised tomography (CT; three shetland ponies) and morphological analysis (one pony and three horses). By means of CT, densities were seen in dependent lung regions early during anaesthesia, both with spontaneous breathing and with mechanical ventilation. The densities remained for some time where they had initially been created when the animal was turned from dorsal to sternal recumbency. Deep insufflation of the lungs reduced the dense area. Gas exchange was impaired roughly in proportion to the dense area. On histological analysis, the densities were atelectatic and congested with blood. Gravimetry showed no more extravascular water per unit lung tissue in the atelectatic than in the 'normal' regions, and the blood content was increased only slightly. It is concluded that the horse develops atelectasis in dependent lung regions early during anaesthesia in dorsal recumbency, and that atelectasis is the most likely explanation for the large shunt and impaired arterial oxygenation regularly seen during anaesthesia.

Nasal epithelium in woodworkers in the furniture industry. A histological and cytological study.

The incidence of nasal adenocarcinoma is greatly increased in wood dust exposed furniture workers. The background is discussed and histological and cytological examinations are performed in 45 workers. The histological findings are compared with different kinds of cytological methods, May-Grünwald-Giemsa and Papanicolau. It was a significant increase in cuboidal cell metaplasia revealed by histology and Papanicolau stained cytology. MGG, on the other hand, revealed significantly raised occurrence of goblet cell hyperplasia. These findings are discussed in relation to a morphogenetical model which could explain some features in the development of premalignant changes which could precede nasal adenocarcinomas.

Experimental studies on carcinogenesis in the nasal mucosa.

Of 24 Syrian golden hamsters exposed to wood dust in a concentration in the air of 30 mg/m3 for 6 h per day, 5 days a week, for a period of 40 weeks, one animal got dysplasia and one a malignant tumour in the nasal mucosa. In a group of 24 animals given 3 mg of diethylnitrosamine subcutaneously once a week for 12 weeks, a high frequency of benign and malignant tumours (mainly adenocarcinoma) of the nasal mucosa was found, but a group of similar size exposed to both wood dust and diethylnitrosamine did not show a higher frequency of nasal tumours than those given this latter substance alone.

Effects of wood dust exposure and diethylnitrosamine. A pilot study in Syrian golden hamsters.

Fine wood dust is epidemiologically associated with human nasal cancer. The aim of the present study was to elaborate an animal model for inhalation studies of the effects of fine wood dust on the upper and lower airways. Syrian golden hamsters were used. After 10 months one animal in the group which was exposed only to wood dust, had developed a malignant nasal tumour and another animal in the same group had nasal dysplasia. Spontaneous nasal tumours in this laboratory animal is not known. Many tumours of the nose, larynx and trachea arose in animals treated with a carcinogen (diethylnitrosamine). There was no increase in tumours in animals with combined exposure to diethylnitrosamine and wood dust.