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At least 757 records · Page 42Linked to original sources

Fomepizole therapy for reversal of visual impairment after methanol poisoning: a case documented by visual evoked potentials investigation.

PURPOSE: To illustrate the safety and efficacy of fomepizole in a case of methanol poisoning with initial visual impairment. DESIGN: Interventional case report. METHODS: A 60-year-old man was admitted with blurred vision and changes in color perception 18 hours after ingesting 100 ml methanol. Fomepizole was chosen for antidotal therapy in combination with hemodialysis. Flash electroretinogram (fERG) and flash visual evoked potentials (fVEPs) examinations were obtained at the bedside 2 hours after admission and on days 1 and 8. The monocular pattern-reversal visual evoked potentials (pVEPs) were investigated on days 1 and 8. RESULTS: A complete reversal of visual impairment was achieved within 20 hours. An abnormal b-wave amplitude and an increased peak III latency at VEPs were present on admission and recovered within 24 hours. CONCLUSIONS: Fomepizole appeared safe and effective for a patient who had severe methanol poisoning presenting with visual impairment.

Alcohol Dehydrogenase↗

[Color ultrasonic angiography in evaluation of chronic prostatitis treatment results].

Fifty-six patients with chronic prostatitis were treated. Routine clinical examinations were supplemented with ultrasonic examination of the prostate via the transurethral access. In addition to the gray-scale examination of prostatic status, color Doppler mapping was carried out in order to evaluate vascular pattern and bloodflow in the prostate. The studies were carried out before and after treatment, which included routine therapy. Suppressed bloodflow in the central and peripheral zones of the prostate (more pronounced inhibition in the peripheral zone) was observed in all patients before treatment. Multiple-modality treatment stimulated function of the main arterioles, arteriovenous shunts were involved in functioning, and prostatic hemodynamics in general was improved, which promoted better delivery of drugs into the focus and eventually eliminated the inflammatory process.

Adolescent↗

Complete remission induced by G-CSF in a patient with acute myeloid leukemia with t(8;21)(q22;q22).

We describe a case of acute myeloid leukemia (AML) with t(8;21) in which complete remission (CR) was obtained with G-CSF given at 10 microg/kg in the absence of concomitant cytotoxic chemotherapy. CR was achieved following 2 weeks of therapy and confirmed by investigating minimal residual disease by four-color flow cytometry analysis. During treatment with G-CSF, maturing cells with cytoplasmic Auer Rods were observed in the peripheral blood, suggesting a differentiation effect. This case adds further evidence for a specific role of G-CSF in the treatment of AML with t(8;21), namely in patients who are not eligible for aggressive chemotherapy.

Acute Disease↗

[Ocular hemodynamics in normal tension glaucoma: effect of bimatoprost].

BACKGROUND: Altered ocular perfusion plays a role in the pathophysiology of normal tension glaucoma. Prostaglandin-like substances are very effective in lowering intraocular pressure. Less data are available regarding the influence of these compounds on ocular perfusion. In the present study the effects of bimatoprost, which has recently been shown to increase the vascular tone of ciliary arteries in vitro, on the blood flow velocity are investigated. PATIENTS AND METHODS: n = 9 eyes from 9 normal tension glaucoma patients were subjected to color Doppler imaging (CDI) before and during a 3 - 5 week therapy with bimatoprost. RESULTS: Bimatoprost reduces intraocular pressure from 14.0 +/- 0.4 to 11.0 +/- 0.5 mmHg (n = 9; P < 0.001). Systolic as well as diastolic blood flow velocities, resistive index (RI) and pulsatility index (PI), measured by CDI, were unaltered in the presence of bimatoprost. DISCUSSION: Bimatoprost does not influence blood flow velocities in the retrobulbar vessels. The in vitro observation of increased vascular tone in the presence of bimatoprost seems not to be relevant for ocular hemodynamics.

Amides↗

Objective evaluation of improvement in optic neuropathy following radiation therapy for thyroid eye disease.

PURPOSE: While the literature supports the use of radiation therapy for thyroid eye disease, it does not sufficiently describe in detail the results of radiation therapy for optic neuropathy associated with thyroid eye disease. The objective of this study is to quantify the changes in parameters of optic neuropathy after orbital irradiation for thyroid eye disease. METHODS AND MATERIALS: Twelve consecutive patients with optic neuropathy from thyroid eye disease were followed by a single neuro-ophthalmology practice and treated by one radiation oncologist with radiation therapy from 1991 through 1995. All cases were prospectively followed for visual acuity, color vision, mean deviation, and/or foveal sensitivity and afferent pupillary defect. All patients received 2000 cGy in 10 fractions with megavoltage irradiation to the orbits. RESULTS: Ten of 12 patients were evaluated for follow-up (one moved out of this country and one had a stroke, which confounded interpretation of examination results). An analysis was performed retrospectively while treatment and evaluation remained uniform. Five men and five women formed the basis of this study with a median age of 60 years (35-76 years). Nineteen eyes were evaluated for thyroid optic neuropathy. Improvement in optic nerve function occurred in eight of ten patients. Improvement was seen either during radiotherapy or within 2 weeks of completion. No long-term adverse effects were noted. CONCLUSION: This study objectively demonstrates improvement in optic neuropathy from radiation therapy for thyroid eye disease.

Adult↗

The bystander effect in the HSVtk/ganciclovir system and its relationship to gap junctional communication.

The bystander effect (BSE) is an interesting and important property of the herpes thymidine kinase/ganciclovir (hTK/GCV) system of gene therapy for cancer. With the BSE, not only are the hTK expressing cells killed upon ganciclovir (GCV) exposure but also neighboring wild-type tumor cells. On testing a large number of tumor cell lines in vitro, a wide range of sensitivity to bystander killing was found. Since transfer of toxic GCV metabolites from hTK-modified to wild-type tumor cells via gap junctions (GJ) seemed to be a likely mechanism of the BSE, we tested GJ function in these various tumors with a dye transfer technique and pharmacological agents known to affect GJ communication. We confirmed that mixtures of tumor cell resistant to the BSE did not show dye transfer from cell to cell while bystander-sensitive tumor cells did. Dieldrin, a drug known to decrease GJ communication, diminished dye transfer and also inhibited the BSE. Forskolin, an upregulator of cAMP did increase GJ, but directly inhibited hTK and therefore its effect on BSE could not be determined. We conclude that these observations further support port the concept that functional GJ play an important role in the BSE and further suggest that pharmacological manipulation of GJ may influence the outcome of cancer therapy with hTK/GCV.

Animals↗

Botulinum toxin as adjunct for refractory compressive optic neuropathy in Graves' disease.

An euthyroid patient was referred for compressive optic neuropathy in Graves' disease. Under prednisone therapy the right and left visual acuities were 1.0 and 0.4, with a profound decrease in color vision on the left. Bilateral anterior orbital decompressions were performed. When prednisone was withdrawn postoperatively, the visual acuity of the right eye dropped to 0.32 with bilateral complete failure on the Ishihara color test. A biopsy of the inferior oblique muscle of the left eye confirmed Graves' disease and additional transantral decompression of the right orbital apex was performed. Under intravenous methylprednisolone therapy, the visual acuity dropped postoperatively to 0.2 and 0.4, respectively. 15 U botulinum toxin were given by retrobulbar injection between the inferior and lateral rectus muscles. Four days later the patient called and said that the visual acuity in the right eye had improved tremendously. Two weeks after the injection the visual acuity was 0.7 in both eyes, although prednisone had been reduced to 20 mg by that time. The convergent strabismus had increased but the already severely restricted motility of the right eye had been little affected by the retrobulbar injection, and adduction not at all. Orbital CT-scan showed thinning of the inferior and lateral rectus muscles, but not of the medial rectus.

Journal Article↗

Placebo attribution in methadone patients.

The effect of external cues on the attributed effectiveness of a placebo was evaluated with methadone patients and a nonaddict control group. Two sources of external feedback, implicit dosage strength (liquid drug color) and explicit performance information (pursuit rotor feedback), were varied along with drug usage. The results indicated that the methadone patients made significantly greater placebo attributions and relied more upon the external cues in making those attributions than did the nonaddict control group. Implications for drug therapy are presented.

Adolescent↗

Optic neuritis treatment trial. One-year follow-up results.

OBJECTIVE: To determine the efficacy of corticosteroids as treatment for acute demyelinative optic neuritis after completion of 1 year of patient follow-up in the Optic Neuritis Treatment Trial. DESIGN: Randomized placebo controlled multicenter clinical trial. SETTING: Fifteen university or hospital-based centers throughout the United States. PATIENTS: Four hundred fifty-seven patients with acute demyelinative optic neuritis between 18 and 46 years of age. INTERVENTION: Either intravenous methylprednisolone sodium succinate (250 mg every 6 hours) for 3 days followed by oral prednisone (1 mg/kg per day) for 11 days, oral prednisone (1 mg/kg per day) for 14 days, or oral placebo for 14 days. The first two regimens were followed by a short taper of corticosteroid therapy. MAIN OUTCOME MEASURES: Visual acuity, visual field, contrast sensitivity, and color vision. RESULTS: Visual acuity at 1 year was 20/40 or better in 95% of the placebo group, 94% of the intravenous group, and 91% of the oral prednisone group. Comparing each corticosteroid group with the placebo group, there were no statistically significant differences in the distributions of any of the four measures of visual function. Patients in the oral prednisone group suffered a higher rate of new attacks of optic neuritis than patients in either of the other two groups. CONCLUSIONS: The visual benefit from treating acute optic neuritis with intravenous followed by oral corticosteroids is short term, limited to an accelerated rate of recovery. The decision whether to prescribe this regimen for optic neuritis, or to prescribe no treatment, must be made for each patient on an individual basis. Oral prednisone alone, in the dose range used in the Optic Neuritis Treatment Trial, should not be prescribed.

Acute Disease↗

Automated assessment of noninvasive filling pressure using color Doppler M-mode echocardiography.

Assessment of left ventricular filling pressure usually requires invasive hemodynamic monitoring to follow the progression of disease or the response to therapy. Previous investigations have shown accurate estimation of wedge pressure using noninvasive Doppler information obtained from the ratio of the wave propagation slope from color M-mode (CMM) images and the peak early diastolic filling velocity from transmitral Doppler images. This study reports an automated algorithm that derives an estimate of wedge pressure based on the spatiotemporal velocity distribution available from digital CMM Doppler images of LV filling.

Adult↗

p16 tumor suppressor therapy in salivary adenoid cystic carcinoma cell line SACC83.

OBJECTIVE: This study aimed to determine the growth inhibitory effects of transfecting the wild-type p16 gene into human salivary adenoid cystic carcinoma (SACC) cells in vitro. METHODS: p16 cDNA was cloned into pDOR-neo plasmid by recombination technique, and the human eukaryotic expression vector, pDOR-p16 , was constructed. P16 gene was transfected into SACC83 cells using the liposome method, and the expression of the transfected genes was detected by RT-PCR. The efficacy of transfection was determined by MTT-based colorimetric formats. The DNA metabolic rate of transfected cells was measured by 3 H-TdR incorporation. To describe the cell division phase, the cell cycles of the p16 -transfected gene cells and untransfected cells were analyzed by flow cytometry. RESULTS: The growths in vitro of the p16-transfected cells were inhibited significantly. 3H-TdR incorporation showed a decreased DNA metabolic rate of p16-transfected cells, and flow cytometry suggested a significant increase of the cells in the G1 phase and decrease in the S phase. CONCLUSION: The study confirmed the reversal effect of wild-type p16 on malignant phenotype of the salivary adenoid cystic carcinoma and provides valuable data for further clinical trial of gene therapy with p16.

Carcinoma, Adenoid Cystic↗

A randomized controlled trial of aspirin in patients with abnormal uterine artery blood flow.

OBJECTIVE: To evaluate color Doppler imaging of the uterine arteries as a screening test in nulliparous women, and to examine the role of low-dose aspirin therapy in pregnancies with abnormal uteroplacental resistance. METHODS: At the routine 18-week fetal morphology ultrasound scan, 955 nulliparous women underwent color Doppler imaging of the uterine arteries. Abnormal uteroplacental vascular resistance was defined with respect to both the systolic-diastolic ratio of the flow velocity waveform and the presence of an ipsilateral early diastolic notch. Those with abnormal uterine artery waveforms were asked to participate in a randomized controlled trial of aspirin therapy. Pregnancy outcomes were compared in women with normal or abnormal flow velocity waveforms, as well as in the two arms of the intervention study. RESULTS: Of 186 women with abnormal uteroplacental resistance according to criteria defined previously, 102 agreed to randomization to either low-dose aspirin (100 mg/day) or placebo for the remainder of the pregnancy. Abnormal uterine artery flow velocity waveforms were associated with statistically significant increases in preeclampsia (11 versus 4%), birth weight below the tenth percentile (28 versus 11%), and adverse pregnancy outcome (45 versus 28%). Prophylactic aspirin therapy did not result in a significant reduction in pregnancy complications. CONCLUSION: Abnormal uteroplacental resistance at 18 weeks' gestation was associated with a significant increase in adverse pregnancy outcome. Low-dose aspirin did not reduce pregnancy complications in women with uteroplacental insufficiency.

Adult↗

Dominant and marginalized discourses in interracial couples' narratives: implications for family therapists.

This study explores inter-racial couples' family histories, their experiences of their life together, and the dominant and subordinate discourses employed in negotiating racial and ethnic differences. Ten black-white couples were interviewed individually and conjointly. Dominant discourses that emerged from the couples' narratives included those of homogamy, hypersensitivity of persons of color, and the insignificance of familial and societal history. Interracial partners also simultaneously subverted these prevailing ideologies by voicing experience associated with life at the margins of the society. Dominant and subordinate dicourses used by therapists and interracial couples in the therapy room are examined to integrate marginalized "truths" crucial to effective work with interracial couples and persons of color.

Adaptation, Psychological↗

Selective reduction and recovery of invariant Valpha24JalphaQ T cell receptor T cells in correlation with disease activity in patients with systemic lupus erythematosus.

OBJECTIVE: To study the regulatory role of CD4-CD8- double-negative (DN) invariant T cell receptor (TCR) Valpha24JalphaQ T cells, a human counterpart of murine NK 1 + T cells, in the autoimmune process of systemic lupus erythematosus (SLE). METHODS: We carried out a 2 step frequency analysis of DN Valpha24JalphaQ T cells in patients with SLE before and after prednisolone therapy; the frequency of DN Valpha24+ T cells was determined by 3 color FACS analysis and subsequently the frequency of Valpha24JalphaQ rearrangement among DN Valpha24+ T cells was determined by sequencing. RESULTS: DN Valpha24+ T cells were significantly increased in patients with active SLE compared to healthy subjects. In healthy subjects, invariant Valpha24JalphaQ TCR dominated in DN Valpha24+ T cells at a high frequency (93-100%). However, the invariant Valpha24JalphaQ TCR was not detected in DN Valpha24+ T cells from patients with active SLE, and instead 2 to 9 Jalpha genes other than the invariant JalphaQ were oligoclonally expanded in the patients. In inactive SLE induced by prednisolone therapy, the invariant Valpha24JalphaQ TCR could be detected in DN Valpha24+ T cells from all the patients and dominated in most of the patients. Further, oligoclonally expanded Valpha24+ clones other than the invariant JalphaQ gene in active disease states were significantly decreased by prednisolone therapy. CONCLUSION: The selective reduction of DN invariant Valpha24JalphaQ T cells is related to the disease progression of SLE, while DN TCR Valpha24 T cells other than Valpha24JalphaQ T cells constitute autoaggressive T cells in SLE.

Adult↗

Color vision deficiencies: a common sign of intoxication in chronically digoxin-treated patients.

On the basis of anamnestic data from digitalis-intoxicated patients, rates of general disorders of vision between 6 and 20% have been reported. We used a psychophysical method, an automatically evaluated Farnsworth's Munsell 100-Hue Test, to detect color vision deficiencies in patients who received beta-methyldigoxin or beta-acetyldigoxin for at least 4 weeks as maintenance therapy. Patients were subgrouped according to serum digoxin concentrations measured by radioimmunoassay. There was a significant correlation between extent and rate of color vision deficiencies and serum digoxin concentrations. About 80% of the intoxicated patients showed generalized color vision deficiencies.

Acetyldigoxins↗

Saline lavage with substitution of bovine surfactant in term neonates with meconium aspiration syndrome (MAS) transferred for extracorporeal membrane oxygenation (ECMO): a pilot study.

BACKGROUND: Meconium aspiration syndrome (MAS) is still a condition associated with a high mortality, and many patients require extracorporeal membrane oxygenation (ECMO) as rescue therapy. Beneficial effects of surfactant and perflubron lavage have been reported. However, pure surfactant supplementation has not been proven to be beneficial in the most severe forms of MAS. This study was performed to demonstrate an improvement in oxygenation in neonates transferred for ECMO and fulfilling ECMO criteria with a saline lavage and surfactant resupplementation. METHODS: Twelve newborns with MAS [gestational age 36-40 weeks, mean birth weight 3200 g, age 4-16 h, oxygenation index (OI) > 40] transferred for ECMO therapy were treated with saline lavage (5-10 cm3/kg body weight, as long as green colored retrieval was observed) and resupplementation with bovine surfactant (Alveofact, Boehringer, Ingelheim, Germany). The OI at admission and 3 h after this procedure was compared using the t-test for paired samples. ECMO was available as rescue therapy at all times. RESULTS: The OI decreased from 49.4 (SD +/- 13.3) to 27.4 (SD +/- 7.3), P < 0.01. The decrease was sustained in nine patients, three patients required ECMO and all patients survived. CONCLUSIONS: As MAS is a condition with parenchymal damage, pulmonary hypertension and obstructive airway disease, no simple causative therapy is possible. Surfactant application after removal of meconium by extensive lavage is feasible as long as 16 h after birth even in infants considered for ECMO therapy; it might reduce the necessity of ECMO.

Journal Article↗

Correlation of serum estrogen levels with uterine and carotid arteries flow in postmenopausal women on hormone replacement therapy.

OBJECTIVE: To determine the pattern of blood flow in the patients compliant and non-compliant to hormone replacement therapy. METHODS: In the period of 12 months, 106 postmenopausal women were examined by the color and pulsed Doppler ultrasonography of the blood flow through uterine, common, and internal carotid arteries (Resistance Index, RI). The study was retrospective-descriptive. Patients were divided into three groups: (1) 38 patients compliant with hormone replacement therapy and daily using Premarin/Provera, (2) 27 patients non-compliant with the treatment because of discontinuation of the therapy and/or irregular use of medicine, and (3) control group of 41 women who never used hormone replacement therapy. Results were compared with serum estrogen (E2) drawn on the day of the blood flow assessment. RESULTS: Mean E2 serum concentration in the hormone replacement therapy-compliant group was 90.1 pg/mL, 45.5 pg/mL in the non-compliant group, and 26.6 pg/mL in the control group (p<0.01). Serum E2 concentration correlated with the decrease in resistance to blood flow in the uterine artery (p=0.001), but did not in the common carotid (p=0.34) and internal carotid arteries (p=0.66). The compliant group and control group differed in the uterine artery blood flow (RI 0.78 vs. 0.87, respectively). CONCLUSION: Differences in E2 serum concentration between the groups are related to the hormone replacement therapy and the patients' compliance to the therapy. Small peripheral arteries readily respond to the serum E2 levels, whereas large peripheral arteries (common and internal carotid) are too "rigid" to respond to E2-induced vasodilatation.

Adult↗

New biofeedback therapy in children with encopresis.

Biofeedback therapy was performed in 13 patients with encopresis using newly devised computerized equipment. The patients were children, aged 6 to 11 years, who had not responded to trials of conventional therapy with a mean follow-up period of three years and two months. The biofeedback therapy was effective in 12 of the 13 patients after one course of therapy. This positive results was attributed to the computerized equipment. The patients could more easily recognize how to squeeze their anal sphincters after seeing a colored ellipse representing sphincter pressure on a monitor. The results of anorectal manometry and electromyography (EMG) showed that biofeedback therapy improved the voluntary sphincter function and rectal sensation. Therefore, biofeedback therapy might be effective in patients with encopresis whose sphincter functions are intact.

Anal Canal↗