RESERVASI PAN AMERICA SYSTEM (PAN) MENURUT HUKUM PERJANJIAN INTERNASIONAL

Tujuan dilakukannya penelitian ini untuk mengetahui apa saja syarat dalam memberikan reservasi menurut Pan America System dan bagaimanakah implikasi hukum persyaratan Pan America System terhadap negara peserta menurut hukum perjanjian internasional, di mana dengan menggunakan metode penelitian hukum normatif disimpulkan: 1. Prinsip Pan American system  tidak diperlukan persetujuan (consent) yang bulat daripada para peserta konvensi atas reservasi/pensyaratan yang diadakan oleh negara yang hendak turut serta dalam konvensi, melainkan konvensi itu dianggap berlaku dengan pensyaratan yang diajukan antara yang mengajukan pensyaratan dengan yang menerima pensyaratan. Sedangkan diantara negara-negara yang menolak pensyaratan dengan negara yang mengajukan pensyaratan, konvensi itu dianggap tidak berlaku. Sehingga Prasyarat utama dalam persyaratan sesuai doktrin ini adalah kesepakatan antara peserta perjanjian secara “pribadi” antara negara satu dengan negara lain terhadap penerimaan persyaratan yang diajukan. Sehingga akibat hukum dari perjanjian tersbut hanya berlaku bagi kedua negara yang bersepakat. 2. Berdasarkan pendapat hukum (advisory opinion) Mahkamah Internasional mengenai implikasi hukum persyaratan ialah (a) negara yang telah membuat dan mempertahankan persyaratan yang telah ditolak oleh negara-negara peserta lain dalam konvensi, tetap dapat menjadi pihak dalam konvensi tersebut sesuai dengan maksud dan tujuan dari konvensi; (b) jika salah satu negara peserta konvensi keberatan pada persyaratan yang diajukan pihak lain dalam persyaratan yang tidak dilarang dalam konvensi, maka negara tersebut dapat menganggap negara yang melakukan persyaratan bukan pihak dalam konvensi, sebaliknya bagi yang menyetujui persyaratan yang diajukan, maka negara yang mengajukan persyaratan adalah sebagai pihak dalam konvensi; (c) Keberatan akan adanya persyaratan bagi negara penandatangan yang belum meratifikasi konvensi dapat menimbulkan efek hukum seperti yang ditunjuk dalam jawaban atas pertanyaan (a), hanya jika mengadakan ratifikasi. Dengan kata lain tindakan tersebut hanya perlu mendapat perhatian bagaimana sikap dari negara penandatangan.Kata kunci: perjanjian internasional; pan america system

Imipenem in der intravenösen antibiotischen Prophylaxe und Therapie der experimentellen Endophthalmitis durch Staphylococcus aureus

Trotz der üblichen prophylaktischen Maßnahmen im Rahmen der Operationsvorbereitung können Erreger nachgewiesenermassen während der Operation ins Auge gelangen. Die perioperative systemische Gabe von Imipenem kann eventuell ins Augeninnere gelangte Erreger sterilisieren, zumindest bis zu einem bestimmten Maximum an Organismen. Im ersten Teil der vorliegenden Arbeit im tierexperimentellen Modell am phaken Kaninchenauge war es möglich, sämtliche mit 100 CFU S. aureus inifizierten Augen zu sterilisieren, falls diese 8 Stunden und eine halbe Stunde vor Infektion, sowie 8 Stunden nach Infektion intravenös Imipenem erhielten. Bei einer Erregermenge von 10 000 CFU waren noch 5 von 6 Augen steril, bei 10 000 CFU nur noch 3 von 6 Augen. Weiterhin scheint es möglich, den Glaskörper durch alleinige intravenöse Imipenemgabe sterilisieren zu können, wenn eine bestimmte Anzahl von intraokulären Keimen nicht überschritten wird. Im zweiten Teil dieser Arbeit wurden Augen mit 1000 CFU S. aureus infiziert und nach 24 Stunden intravenöse Therapie mit Imipenem oder der in der EVS verwendeten Kombination Ceftazidim und Amikazin begonnen. Nach 7 Tagen waren signifikant geringere Erregermengen in den mit Imipenem behandelten Augen festzustellen, als in mit Ceftazidim und Amikazin behandelten oder der unbehandelten Kontrollgruppe. 4 von 6 mit Imipenem therapierten Augen waren zu diesem Zeitpunkt steril. Ob es möglich ist, eine Endophthalmitis in einem derart frühen Stadium zu diagnostizieren und dann intravenös ohne intraokuläre Antibiotikaeingabe befriedigend therapieren zu können ist jedoch fraglich, denn in dieser Studie waren selbst in Augen mit negativem Kulturergebniss massive Entzündungszeichen festzustellen. Im dritten Teil dieser Arbeit stellte sich die intraokuläre Eingabe von Vancomycin und Amikacin als der alleinigen systemischen Imipenemgabe deutlich überlegen heraus, sowohl im Hinblick auf Erregermengen, klinischen Verlauf und histopathologisches Erscheinungsbild. Zu einem frühen Zeitpunkt der Infektion gegeben, können intraokuläres Vancomycin und Amikacin in diesem Tierexperiment relativ klare optische Medien ohne zusätzlich chirurgische Therapie erhalten. In dem hier durchgeführten Experiment erbrachte die zusätzliche intravenöse Therapie mit Imipenem keine messbare Verbesserung gegenüber der alleinigen intravitrealen Therapie mit Vancomycin und Amikacin

Hyalocyte origin, structure, and imaging

Hyalocytes have been recognized as resident tissue macrophages of the vitreous body since the mid-19th century. Despite this, knowledge about their origin, turnover, and dynamics is limited. Historically, initial studies on the origin of hyalocytes used light and electron microscopies. Modern investigations across species including rodents and humans will be described. Novel imaging is now available to study human hyalocytes in vivo. The shared ontogeny with retinal microglia and their eventual interdependence as well as differences will be discussed. Owing to a common origin as myeloid cells, hyalocytes and retinal microglia have similarities, but hyalocytes appear to be distinct as resident macrophages of the vitreous body.</p

Manual Khalifa Therapy Improves Functional and Morphological Outcome of Patients with Anterior Cruciate Ligament Rupture in the Knee: A Randomized Controlled Trial

Rupture of the anterior cruciate ligament (ACL) is a high incidence injury usually treated surgically. According to common knowledge, it does not heal spontaneously, although some claim the opposite. Regeneration therapy by Khalifa was developed for injuries of the musculoskeletal system by using specific pressure to the skin. This randomized, controlled, observer-blinded, multicentre study was performed to validate this assumption. Thirty patients with complete ACL rupture, magnetic resonance imaging (MRI) verified, were included. Study examinations (e.g., international knee documentation committee (IKDC) score) were performed at inclusion (t0). Patients were randomized to receive either standardised physiotherapy (ST) or additionally 1 hour of Khalifa therapy at the first session (STK). Twenty-four hours later, study examinations were performed again (t1). Three months later control MRI and follow-up examinations were performed (t2). Initial status was comparable between both groups. There was a highly significant difference of mean IKDC score results at t1 and t2. After 3 months, 47% of the STK patients, but no ST patient, demonstrated an end-to-end homogeneous ACL in MRI. Clinical and physical examinations were significantly different in t1 and t2. ACL healing can be improved with manual therapy. Physical activity can be performed without pain and nearly normal range of motion after one treatment of specific pressure

Growth characteristics in individuals with osteogenesis imperfecta in North America: results from a multicenter study.

PurposeOsteogenesis imperfecta (OI) predisposes people to recurrent fractures, bone deformities, and short stature. There is a lack of large-scale systematic studies that have investigated growth parameters in OI.MethodsUsing data from the Linked Clinical Research Centers, we compared height, growth velocity, weight, and body mass index (BMI) in 552 individuals with OI. Height, weight, and BMI were plotted on Centers for Disease Control and Prevention normative curves.ResultsIn children, the median z-scores for height in OI types I, III, and IV were -0.66, -6.91, and -2.79, respectively. Growth velocity was diminished in OI types III and IV. The median z-score for weight in children with OI type III was -4.55. The median z-scores for BMI in children with OI types I, III, and IV were 0.10, 0.91, and 0.67, respectively. Generalized linear model analyses demonstrated that the height z-score was positively correlated with the severity of the OI subtype (P &lt; 0.001), age, bisphosphonate use, and rodding (P &lt; 0.05).ConclusionFrom the largest cohort of individuals with OI, we provide median values for height, weight, and BMI z-scores that can aid the evaluation of overall growth in the clinic setting. This study is an important first step in the generation of OI-specific growth curves

Correlation between Macular Neovascularization (MNV) Type and Druse Type in Neovascular Age-Related Macular Degeneration (AMD) Based on the CONAN Classification

To investigate associations and predictive factors between macular neovascularization (MNV) lesion variants and drusen types in patients with treatment-naïve neovascular age-related macular degeneration (AMD). Methods: Multimodal imaging was retrospectively reviewed for druse type (soft drusen, subretinal drusenoid deposits (SDDs) or mixed) and MNV type (MNV 1, MNV 2, MNV 1/2 or MNV 3). The Consensus on Neovascular AMD Nomenclature (CONAN) classification was used for characterizing MNV at baseline. Results: One eye of each eligible patient was included (n = 191). Patients with predominant SDDs had an increased adjusted odds ratio (aOR) for MNV 2 (23.4453, p = 0.0025) and any type of MNV 3 (8.7374, p < 0.0001). Patients with MNV 1/2 had an aOR for predominant SDDs (0.3284, p = 0.0084). Patients with MNV1 showed an aOR for SDDs (0.0357, p < 0.0001). Eyes with SDDs only without other drusen types showed an aOR for MNV 2 (9.2945, p < 0.0001). Conclusions: SDDs represent a common phenotypic characteristic in AMD eyes with treatment-naïve MNV. The aOR for eyes with predominant SDDs to develop MNV 2 and MNV 3 was much higher, possibly due to their location in the subretinal space. The predominant druse type may help to predict which type of MNV will develop during the course of AMD