Short-Term Effects of Ginkgo biloba Extract on Peripapillary Retinal Blood Flow in Normal Tension Glaucoma

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.ope

Effects of Acute Hyperoxia on Hyaluronic Acid and Histopathology of the Lung in Neonatal Ratst

We studied the effects of hyperoxia()95% oxygen for 10 days) on changes in body weight, changes in wet to dry lung weight ratio, changes in hyaluronic acid of the lung, and morphologic changes in lung tissue compared with those of normoxia (room air for 10 days) in Sprague-Dawley neonatal rat pups. In this acute hyperoxic neonatal rat model, we tried to analyze the relationship of relative water content of the wet lung and the amount of hyaluronic acid and morphologic change in lung tissue. The results were as follows: 1) Increase of postnatal body weight among survivors was stunted significantly under hyperoxia compared with normoxia during 10 days-experiment. 2) No appreciable difference of wet to dry lung weight ratio was noted on the beginning and the tenth day of experiment in neonatal rat pups between normoxia and hyperoxia, but considerable increased wet to dry lung weight ratio was noted significantly at 5, 7 days of hyperoxia suggesting that the relative water content of the wet lung was increased on the fifth, seventh day of experiment in hyperoxia compared with normoxia, 3) The amount of hyaluronic acid per wet lung decreased sequentially according to increase of postnatal age in normoxia, but a considerably increased amount of hyaluronic acid per wet lung was noted significantly on the fifth, the seventh day of experiment in hyperoxia. The difference in amount of hyaluronic acid per wet lung was not significant on the tenth day of experiment between normoxia and hyperoxia. These results suggested that the changing pattern of amount of hyaluronic acid per wet lung coincided with that of the relative water content of the wet lung in hyperoxia. 4) Pulmonary edema, interstitial inflammatory cell hypercellularity, and localization of hyaluronic acid in interstitial lung lesion were observed by light microscope at 7 days of exposure in hyperoxia compared with normoxia. These results suggest the possible role of hyaluronic acid on increase of water content and interstitial inflammatory cells in acute lung injury due to hyperoxia in an experimental neonatal rat model

Inaccuracy of Intraocular Lens Power Prediction for Cataract Surgery in Angle-Closure Glaucoma

PURPOSE: To assess the accuracy of intraocular lens (IOL) power predictions for cataract surgery in eyes with primary angle-closure glaucoma (ACG). Because of shifting of the capsular bag apparatus and shortening of the axial length, preoperative calculation of IOL power may be inaccurate for eyes with ACG. MATERIALS AND METHODS: This retrospective comparative case series comprised of 42 eyes from 42 patients with primary ACG and 45 eyes from 45 subjects with normal open-angles undergoing uneventful cataract surgery. Anterior segment biometry including anterior chamber depth, lens thickness, and axial length were compared. Using the SRK-II formula, the powers of the implanted IOL and the actual postoperative spherical equivalent (SE) refractive errors were compared between the two groups. Also, the absolute values of differences between predicted and residual SE refractive errors were also analyzed for each group. RESULTS: In ACG patients, anterior chamber depth and axial length were shorter and the lens was thicker than normal controls (all p < 0.001). Even though residual SE refractive error was not significantly different (p = 0.290), the absolute value of the difference between predicted and residual SE refractive error was 0.64 +/- 0.50 diopters in AGC patients and 0.39 +/- 0.36 diopters in control subjects (p = 0.012). The number of eyes that resulted in inaccurate IOL power predictions of more than 0.5 diopters were 21 (50.00%) in the ACG group, but only 12 (26.67%) in the control group (p = 0.043). CONCLUSION: IOL power predictions for cataract surgery in ACG patients can be inaccurate, and it may be associated with their unique anterior segment anatomy.ope

L-Asparaginase delivered by Salmonella typhimurium suppresses solid tumors

Bacteria can be engineered to deliver anticancer proteins to tumors via a controlled expression system that maximizes the concentration of the therapeutic agent in the tumor. L-asparaginase (L-ASNase), which primarily converts asparagine to aspartate, is an anticancer protein used to treat acute lymphoblastic leukemia. In this study, Salmonellae were engineered to express L-ASNase selectively within tumor tissues using the inducible araBAD promoter system of Escherichia coli. Antitumor efficacy of the engineered bacteria was demonstrated in vivo in solid malignancies. This result demonstrates the merit of bacteria as cancer drug delivery vehicles to administer cancer-starving proteins such as L-ASNase to be effective selectively within the microenvironment of cancer tissue

Fixed Subaortic Stenosis In Infants and Children

Fixed subaortic stenosis(FSS) is important because of not only obstruction but also aortic insufficiency. This study was performed to find out the characteristics and combined anomalies of FSS. Echocardiographic and clinical data were reviewed in 31 children who were diagnosed as FSS between March 1985 and February 1991 (age: 2months-12yr7months, M:F = 2:1). Cardiac defects were associated in 26(84%) and the majority of the cases were related to VSD(VSD only: 14 cases, VSD with other anomalies: 7 cases). The type of VSD was perimembranous in 86%(18/21) and subarterial in 14%(3/21). Aortic insufficiency(AO was present in 13 cases(42%) and the degree of AI was usually mild. The mean pressure gradient between the left ventricle and the aorta was 21mmHg by cardiac catheterization in 27. Operative resection was done in 20; 11 during the correction of major defects, 4 for AI, 5 for significant pressure gradient. The pathologic findings of 13 were mainly fibrosis and hypertrophied myocardium. In conclusion, because of the possible association with other cardiac defects, especially perimembranous VSD and its co~rt features, it is recommended to pay attention to the coexistence of FSS during the evaluation of cardiac defects

A Case of Minimal Change Disease Treated Successfully with Mycophenolate Mofetil in a Patient with Systemic Lupus Erythematosus

The World Health Organization classifies lupus nephritis as class I to V or VI. However, a few cases of minimal change glomerulopathy have been reported in association with systemic lupus erythematosus (SLE). Mycophenolate mofetil has been shown to be effective for treatment of minimal change disease and lupus nephritis. A 24-year-old woman diagnosed with SLE five years prior to presentation complained of a mild generalized edema. The urinalysis showed microscopic hematuria and proteinuria. The assessed amount of total proteinuria was 1,618 mg/24 hours. A renal biopsy demonstrated diffuse fusion of the foot processes of podocytes on electron microscopy. Mycophenolate mofetil was started in addition to the maintenance medications of prednisolone 10 mg/day and hydroxychloroquine 400 mg/day. After six months of treatment, the microscopic hematuria and proteinuria resolved, and the total urine protein decreased to 100 mg/24 hours

Effect of prolonged HAART on oral colonization with Candida and candidiasis

BACKGROUND: Progressive cell-mediated immunodeficiency with decrease of CD4+ lymphocyte count to less than or equal to 200 cells/mm(3 )is a major risk factor for colonization with Candida species and development of candidiasis. Oropharyngeal candidiasis may occur in up to 90% of human immunodeficiency virus (HIV)-infected patients during the course of the disease. This study is to determine the effect of prolonged highly active antiretroviral therapy (HAART) on oropharyngeal colonization with Candida species and oral candidiasis. METHODS: A prospective, longitudinal follow-up study in HIV-infected patients receiving HAART. RESULTS: The mean CD4+ count increased from 232.5 to 316 cells/mm(3 )and the proportion of patients whose CD4+ count less than 200 cells/mm(3 )decreased from 50.0% to 28.9% (p = 0.0003) in patients receiving HAART for at least 2 years. The prevalence of oral candidiasis decreased from 10.6% to 2.1% (p = 0.004). The decrease in Candida colonization was less impressive, falling from 57.8% to 46.5 % (p = 0.06). Of the 142 patients enrolled in at least two surveys, 48 (33.8%) remained colonized with Candida and 42 (29.6%) remained negative. In the remaining 52 patients, 34 switched from culture positive to negative, and an increase in CD4+ lymphocytes was noted in 91.2% of them. Among the 18 patients who switched from culture negative to positive, 61.1% also demonstrated an increase in CD4+ lymphocyte count (p = 0.01). CONCLUSION: These findings indicate that HAART is highly effective in decreasing oral candidiasis in association with a rise in CD4+ lymphocyte counts, but only marginally effective in eliminating Candida from the oropharynx