The International Space Station human life sciences experiment implementation process

The selection, definition, and development phases of a Life Sciences flight research experiment has been consistent throughout the past decade. The implementation process, however, has changed significantly within the past two years. This change is driven primarily by the shift from highly integrated, dedicated research missions on platforms with well defined processes to self contained experiments with stand alone operations on platforms which are being concurrently designed. For experiments manifested on the International Space Station (ISS) and/or on short duration missions, the more modular, streamlined, and independent the individual experiment is, the more likely it is to be successfully implemented before the ISS assembly is completed. During the assembly phase of the ISS, science operations are lower in priority than the construction of the station. After the station has been completed, it is expected that more resources will be available to perform research. The complexity of implementing investigations increases with the logistics needed to perform the experiment. Examples of logistics issues include- hardware unique to the experiment; large up and down mass and volume needs; access to crew and hardware during the ascent or descent phases; maintenance of hardware and supplies with a limited shelf life,- baseline data collection schedules with lengthy sessions or sessions close to the launch or landing; onboard stowage availability, particularly cold stowage; and extensive training where highly proficient skills must be maintained. As the ISS processes become better defined, experiment implementation will meet new challenges due to distributed management, on-orbit resource sharing, and adjustments to crew availability pre- and post-increment.

Selective muscarinic receptor antagonists for airway diseases

Airway tone and airway hyperreactivity are mediated by the parasympathetic nerves that release acetylcholine onto muscarinic receptors (M1-M5). Stimulation of M1 and M3 muscarinic receptors causes bronchoconstriction. The M1 muscarinic receptor is excitatory, and facilitates neuronal transmission at the parasympathetic ganglion. The M2 receptor is an inhibitory prejunctional autoreceptor. The discovery of discrete muscarinic receptor subtypes prompted development of selective muscarinic receptor antagonists. Selective M3 receptor antagonists and antagonists selective for M1 and M3 receptors have recently entered clinical trials and offer much promise for the treatment of airways diseases.

Search for neutral supersymmetric Higgs bosons in pp collisions at sqrt[s] = 1.8TeV

We present the results of a search for neutral Higgs bosons produced in association with b quarks in pp-->bb(phi)-->bbb final states with 91+/-7 pb(-1) of pp collisions at sqrt[s] = 1.8 TeV recorded by the Collider Detector at Fermilab. We find no evidence of such a signal and the data are interpreted in the context of the neutral Higgs sector of the minimal supersymmetric extension of the standard model. With basic parameter choices for the supersymmetric scale and the stop-quark mixing, we derive 95% C.L. lower mass limits for neutral Higgs bosons for tan(beta) values in excess of 35.

Long-term follow-up of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy

To determine whether choice of material used for patch closure following carotid artery endarterectomy (CAE) influences rates of early or late restenosis, stroke, and death, 274 consecutive CAEs were retrospectively reviewed. Saphenous vein (SV) was used in 159 (58.0%) procedures; everted, double-thickness jugular vein (JV) was used in 25 (9.1%); and knitted Dacron (KD) was used in 90 (32.9%). Primary closure was not used in this series. There were four perioperative strokes: two (1.3%) in SV, one (4%) in JV, and one (1.1%) in KD (NS). Follow-up was obtained on 263 (96%) operated arteries (mean 41.5 months). Duplex scan results were available for 236 (89.7%) of these arteries (mean follow-up time 33.7 months). There were three (2%) late strokes in SV and two (2.2%) in KD (NS). In long-term follow-up, one patient (0.7%) in SV and two (2.4%) in KD developed > 80% stenosis (NS). One patient (0.7%) in SV, one (5.3%) in JV, and one (1.2%) in KD had total occlusion of the operated vessel (NS). Three procedures (2.2%) in SV, 1 (5.3%) in JV, and 7 (8.5%) in KD demonstrated moderate stenosis (50-79%) (NS). Three-year follow-up shows that choice of patch material does not affect early or late stroke rate, stroke-related death rate, rate of high-grade (> 80%) restenosis, or rate of total occlusion. There is a higher incidence of moderate stenosis in KD. Although our results and a review of the literature do not indicate that these patients are at increased risk for symptoms or progression of stenosis, they should be followed by duplex scanning to ensure that this is the case.

Production of chi(c1) and chi(c2) in pp collisions at sqrt[S] = 1.8 TeV

We have measured the ratio of prompt production rates of the charmonium states chi(c1) and chi(c2) in 110 pb(-1) of pp collisions at sqrt[s] = 1.8 TeV. The photon from their decay into J/psi(gamma) is reconstructed through conversion into e+e- pairs. The energy resolution this technique provides makes the resolution of the two states possible. We find the ratio of production cross sections sigma(chi(c2))/sigma(chi(c1)) = 0.96+/-0.27(stat)+/-0.11(syst) for events with pT(J/psi) > 4.0 GeV/c, /eta(J/psi)/ < 0.6, and pT(gamma) > 1.0 GeV/c.

First measurement of the ratio B(t --> Wb)/B(t --> Wq) and associated limit on the Cabibbo-Kobayashi-Maskawa element /V(tb)/

We present the first measurement of the ratio of branching fractions R identical withB(t-->Wb)/B(t-->Wq) from p_p collisions at sqrt[s] = 1.8 TeV. The data set corresponds to 109 pb(-1) of data recorded by the Collider Detector at Fermilab during the 1992-95 Tevatron run. We measure R = 0.94(+0.31)(-0.24)(stat+syst) or R>0.61 (0.56) at 90% (95)% C.L., in agreement with the standard model predictions. This measurement yields a limit on the Cabibbo-Kobayashi-Maskawa quark mixing matrix element /V(tb)/ under the assumption of three generations and unitarity.

Effectiveness of denuding the intestinal mucosa by submucosal injection in the porcine model

PURPOSE

Lack of mucosal regrowth on denuded bowel segments is considered a prerequisite for successful grafting of cultured urothelial cells for bladder augmentation. This study was designed to establish a technique for clean and complete de-epithelialization of the intestinal mucosa.

MATERIALS AND METHODS

A segment of the small bowel was isolated in six microminipigs. The isolated segment was detubularized and the submucosa injected with HEPES-buffered saline, elevating the mucosa from the underlying tissue and allowing removal with ease. One portion was resected and, along with a portion of the removed mucosa and a sample of the full-thickness bowel, submitted for histologic evaluation. Another portion of the bowel segment remained denuded while the final denuded segment was covered with polyglactin mesh. After 3 days, 1 week, and 3 weeks, specimens from each of the bowel segments were collected for histologic assessment. Immunoperoxidase labeling was performed to confirm the presence or absence of mucosal regrowth.

RESULTS

All intestinal segments showed no mucosal regrowth at the 3-day, 1-week, and 3-week incubation periods. Minimal reaction between the denuded bowel segment and the mesh was evident in all of the pigs.

CONCLUSIONS

In the porcine model, intestinal mucosa can be removed completely using submucosal injection. This technique may be useful in future clinical studies involving bladder augmentation using denuded bowel.

Rationales for Food Refusal in Chinese Patients with Anorexia Nervosa

OBJECTIVE

To study the rationales for food refusal among Chinese patients with typical and atypical anorexia nervosa.

METHOD

Forty-eight consecutive patients with broadly defined anorexia nervosa underwent evaluation with a self-report rationale for food refusal questionnaire, the 12-item General Health Questionnaire (GHQ-12), the 21-item Beck Depression Inventory (BDI-21), the Hamilton Depression Rating Scale (HDRS), and other clinical assessments.

RESULTS

Fat-phobic patients (N = 32) had a significantly higher premorbid body mass index than non-fat-phobic patients (N = 16), but they did not differ on other clinical parameters, GHQ-12, BDI-21, and HDRS scores. At clinical presentation, 3 months, and 1 year prior to presentation, fat phobia and stomach bloating were the most common rationales for food refusal among fat-phobic and non-fat-phobic patients, respectively. A total of 31% of fat-phobic patients endorsed non-fat-phobic rationales at the time of clinical presentation, whereas non-fat-phobic patients adhered to non-fat-phobic attributions more consistently.

DISCUSSION

The rationales used by anorexic patients to explain noneating are more varied than implied in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders and the ICD-10 Classification of Mental and Behavior Disorders: Clinical Descriptions and Diagnostic Guidelines. A broadened conceptualization of anorexia nervosa may enhance an understanding of patients' illness experiences and enliven research on eating disorders.

Measurement of J/psi and psi(2S) polarization in pp collisions at sqrt[s] = 1.8 TeV

We have measured the polarization of J/psi and psi(2S) mesons produced in pp collisions at sqrt[s] = 1.8 TeV, using data collected at the Collider Detector at Fermilab during 1992-1995. The polarization of promptly produced J/psi [psi(2S)] mesons is isolated from those produced in B-hadron decay, and measured over the kinematic range 4 [5.5]<P(T)<20 GeV/c and |y|<0.6. For P(T) greater than or approximately equal 12 GeV/c we do not observe significant polarization in the prompt component.

The variability of phenomenology in anorexia nervosa

OBJECTIVE

To study the variability of phenomenology in Chinese patients with anorexia nervosa in Hong Kong.

METHOD

Longitudinal case studies of four patients.

RESULTS

The anorexic illness was not uniformly about the fear of fatness. Rather, patients' explanations for food refusal could change over time. A typology of anorexic phenomenology emerged; namely, fat phobic type I (fat phobia consistently present), fat phobic type II (fat phobia changing to non-fat phobic presentation), non-fat phobic type I (consistently non-fat phobic) and non-fat phobic type II (non-fat phobic initially, but fat phobic later).

CONCLUSION

The variability of anorexic phenomenology challenges the current fat phobia paradigm and has implications on the diagnosis, treatment and psychometric assessment of eating disorders.

Five wave mixing: surface-specific transient grating spectroscopy as a probe of low frequency intermolecular adsorbate motion

Surface-specific five wave mixing spectroscopy is used to examine adsorbate dynamics at the fused silica/air interface. Signals whose temporal response is significantly broader than the instantaneous fourth-order electronic polarizability are attributed to low frequency, adsorbate nuclear motion. Based on the dependence of these dynamics on the moment of inertia and their comparison with dynamics observed in liquids, the five wave mixing temporal response has been assigned to adsorbate intermolecular librational motion. Demonstration of this new fourth-order technique allows one, in principle, to extend all third-order nonlinear bulk-phase spectroscopies to surfaces and interfaces with specificity.

Ethanol reinforcement in nondeprived mice: effects of abstinence and naltrexone

BACKGROUND

Operant experiments which indicate that ethanol can serve as a reinforcer to maintain lever responding during limited periods of access have not been conducted on non-food-deprived mice, as they have for rats and monkeys. Furthermore, there are no reports of the effects of chronic ethanol and subsequent abstinence on ethanol reward in mice. Finally, although naltrexone reduces responding for ethanol in food-deprived mice, the effects of the drug on ethanol reward for non-food-deprived mice have not been reported.

METHODS

In three experiments, lever responding for ethanol (10-12%) was established in C57BL/6 (B6) mice by using either sucrose or saccharin fading procedures commonly used for rats. Experiment 1 examined both appetitive and consummatory responses while sucrose was faded from the ethanol solutions. Experiment 2 examined lever responding and ethanol intake (1) during saccharin fading; (2) when reinforcement schedules, reward availability, and primary conditioned reinforcers were manipulated; and (3) when mice were allowed chronic ethanol consumption followed by forced abstinence. Experiment 3 examined the effects of low doses of naltrexone on ethanol reward.

RESULTS

Lever responding for ethanol can be established in non-food-deprived mice with the sucrose and saccharin fading procedures commonly used for rats. Lever responses increased with decreases in the reinforcer and increases in schedule demand, which indicated the reward value of the ethanol solution. Removal of ethanol from the solution reduced consumption with no change in the appetitive, instrumental response, which indicated that the two responses were under control of different stimuli, perhaps mediated by different neural mechanisms. Forced abstinence after chronic ethanol exposure increased responding for the drug, which suggested increased reward value. Naltrexone reduced responding as previously reported for food-deprived B6 mice.

CONCLUSIONS

Ethanol appears to serve as a reinforcer for non-food-deprived or non-water-deprived B6 mice. Its reinforcing effects are increased by forced abstinence after chronic exposure and are decreased by naltrexone.

Search for scalar top and scalar bottom quarks in pp collisions at square root s=1.8 TeV

We have searched for direct pair production of scalar top and scalar bottom quarks in 88 pb-1 of pp collisions at sqrt[s]=1.8 TeV with the CDF detector. We looked for events with a pair of heavy flavor jets and missing energy, consistent with scalar top (bottom) quark decays to a charm (bottom) quark and a neutralino. The numbers of events that pass our selections show no significant deviation from standard model expectations. We compare our results to the next-to-leading order scalar quark production cross sections to exclude regions in scalar quark-neutralino mass parameter space.

Search for a W' boson via the decay mode W'-->munumu in 1.8 TeV pp collisions

We report the results of a search for a W' boson produced in pp collisions at a center-of-mass energy of 1.8 TeV using a 107 pb-1 data sample recorded by the Collider Detector at Fermilab. We consider the decay channel W'-->&munumu and search for anomalous production of high transverse mass munumu lepton pairs. We observe no excess of events above background and set limits on the rate of W' boson production and decay relative to standard model W boson production and decay using a fit of the transverse mass distribution observed. If we assume standard model strength couplings of the W' boson to quark and lepton pairs, we exclude a W' boson with invariant mass less than 660 GeV/c2 at 95% confidence level.

Disordered eating in three communities of China: a comparative study of female high school students in hong kong, Shenzhen, and rural hunan

OBJECTIVE

To examine disordered eating and its psychological correlates among female high school students in three Chinese communities that lay on a gradient of socioeconomic development in China.

METHOD

796 Chinese students from Hong Kong, Shenzhen, and rural Hunan completed a demographic and weight data sheet, the Eating Attitudes Test (EAT-26), a Body Dissatisfaction Scale (BDS), the Beck Depression Inventory (BDI), and the Rosenberg Self-Esteem Scale (RSES).

RESULTS

Compared to students in Hunan and to a lesser extent students in Shenzhen, students from Hong Kong were slimmer, but desired a lower body mass index (BMI), reported more body dissatisfaction, exhibited a more typical EAT-26 factor structure, scored higher on the "fat concern and dieting" factor, and constituted more EAT-26 high scorers. Multiple regression analyses indicated that BDS was the most significant predictor of fat concern at each site, but this effect was strongest in Hong Kong. Hunan students had significantly higher BDI scores but lower fat concern than Shenzhen and Hong Kong students.

DISCUSSION

The consistent gradient of fat concern across the three communities gives credence to the view that societal modernization fosters disordered eating in women, possibly via the gendered social constraints that accompany it. It is also expressive of the marked socioeconomic heterogeneity within China nowadays. The predictable rising rate of eating disorders that follows global change will pose a growing public health challenge to Asian countries.

Psychiatric morbidity and illness experience of primary care patients with chronic fatigue in Hong Kong

OBJECTIVE

The authors' goal was to examine the prevalence and experience of psychiatric morbidity among primary care patients with chronic fatigue in Hong Kong.

METHOD

One hundred adult patients with medically unexplained fatigue for 6 or more months were assessed with the Explanatory Model Interview Catalogue, psychopathological rating scales, and an enhanced version of the Structured Clinical Interview for DSM-III-R.

RESULTS

The lifetime prevalence of DSM-III-R depressive and anxiety disorders was 54%. Current depressive and anxiety disorders were identified in 28 patients, who exhibited more psychopathology and functional impairment than other patients. Thirty-three patients had somatoform pain disorder, and 30 had undifferentiated somatoform disorder, but most of them could also be diagnosed as having shenjing shuairuo (weakness of nerves) and, to a lesser extent, ICD-10 neurasthenia. Chronic fatigue syndrome diagnosed according to the 1988 Centers for Disease Control criteria was rare (3%) and atypical. Generally, patients mentioned fatigue if asked, but pains (36%), insomnia (20%), and worries (13%) were the most troublesome symptoms. Most patients attributed illness onset to psychosocial sources.

CONCLUSIONS

Psychiatric morbidity was common among primary care patients with chronic fatigue. Subthreshold psychiatric morbidity was very common and was more validly represented by the disease construct of shenjing shuairuo or neurasthenia than somatoform disorder.

[Tyrosine kinase expression in the inner ear of mice]

Tyrosine-specific phosphorylation events serve to modulate cell to cell interactions during the normal growth and development of many vertebrate tissues. Numerous studies have been performed on the involvement of growth factor receptor tyrosine kinases (RTKs) in inner ear function. Many RTKs, however, have only been recently identified, and their expression patterns have not yet been systematically examined in all tissues. In this study, we surveyed mouse inner ear transcript sequences for the presence of RTKs using a degenerate-PCR based methodology. Isolates encoding RTKs that had and had not been previously identified in the inner ear were obtained. Our data reveals the presence of numerous RTKs in the inner ear that have not yet been studied in the context of inner ear and demonstrates the usefulness of RT-PCR analysis in identifying genes involved in inner ear function.

Wrapping hydroxyapatite orbital implants with posterior auricular muscle complex grafts

PURPOSE

To report the use of posterior auricular muscle complex grafts as a wrapping material for hydroxyapatite orbital implants in enucleation surgery.

METHOD

In a retrospective multicenter study, autogenous posterior auricular muscle complex grafts were used to cover hydroxyapatite orbital implants in 83 patients with a mean age of 38.6 years (range, 1 to 85 years), of whom 63 had primary unilateral enucleation and 20 had secondary orbital implants following enucleation. The mean follow-up period after posterior auricular muscle complex grafts was 36 months (range, 14 to 60 months).

RESULTS

Of the 83 patients, two (2.4%) developed limited orbital implant exposure, which was treated with a second posterior auricular muscle complex "patch graft." No patient developed postoperative orbital infection or implant extrusion. All patients were fitted with an acceptable prosthesis and had satisfactory cosmetic and functional results. No patient developed vascular compromise or a wound defect associated with the posterior auricular donor site.

CONCLUSION

Autogenous posterior auricular muscle complex grafts should be considered as an appropriate wrapping material for hydroxyapatite orbital implants for primary enucleation and for secondary orbital implants after enucleation.

Immediate and late explantation of endovascular aortic grafts: the endovascular technologies experience

PURPOSE

The morbidity and clinical outcome of the failure to successfully repair an abdominal aortic aneurysm with Endovascular Technologies (EVT) grafts, resulting in explantation of the device, was assessed.

METHODS

The records of all patients worldwide undergoing attempted endovascular repair with EVT devices from February 1993 to October 1997 were retrospectively reviewed. Of 669 patients, 19 (3%) were converted to open procedure with immediate explantation during the initial attempt at endovascular repair, and 27 patients (4%) required explantation at a later date, ranging from 1 day to 40 months. The incidence, morbidity, mortality, and effect on clinical outcome were evaluated.

RESULTS

Causes of immediate conversion with explantation were: inaccurate deployment of the proximal or distal attachment systems (11 of 19; 58%); twists in the system (3 of 19; 16%); mechanism malfunction during deployment (4 of 19; 21%); and an aortic tear (1 of 19; 5%). Among the 27 patients undergoing late explantation, 20 (74%) did so because of persistent endoleaks. Three cases (11%) were performed because of aneurysm rupture, three (11%) because of graft occlusion, one because of aortic dissection (4%), and one (4%) because of graft migration into the aneurysm sac. The overall perioperative mortality rate was 11% (2 of 19) for immediate explantation and 7% (2 of 27) for late explantation. The average length-of-stay was 11 days for immediate explantation and 14 days for late explantation (NS). Complications included myocardial infarction (4%), pulmonary insufficiency (13%), wound infection (4%), and permanent renal failure (2%). There were no significant differences in the incidence rates of these complications between immediate and late explants. No cases of limb loss occurred. Median American Society of Anesthetists (ASA) classification was 3, and there was no correlation between ASA classification and mortality rate. Average operating time was 374 minutes for immediate explantation (including the time for the failed endovascular procedure) and 185 minutes for late explantation.

CONCLUSION

Immediate and late explantation are infrequent events, occurring in 3% and 4%, respectively, of attempted EVT endovascular aortic stent placements. The mortality rate was higher for both immediate (11%; P <.05) and late (7%; NS) explantation when compared with the mortality rate of all patients undergoing EVT aortic endograft placement (1.5%). There does not appear to be increased long-term morbidity among patients undergoing successful explantation. Early recognition of the need to convert to open procedure, device improvement, and increased operator experience should continue to minimize the incidence of immediate and late explantation and their associated complications.

Report of a single-institution experience using the EVT endovascular abdominal aortic aneurysm graft in 25 patients

The purpose of this study was to review a single-institution experience with the Endovascular Technologies [(EVT) Menlo Park, CA] transfemoral, endovascular system of abdominal aortic aneurysm repair. This study was performed at a medical center participating in the phase 1 and phase 2 evaluations of the EVT device. We reviewed the 25 cases performed at our institution. The patient population consisted of 21 males (84%) and 4 females (16%), with a mean age of 73.4 years. A total of eight tube grafts (32%) and 17 bifurcated grafts (68%) were attempted. Twenty-two of the twenty-five grafts were successfully implanted endovascularly (88%). Implantation failures were due to tortuosity or inadequate caliber of the iliac arteries, or incorrect positioning of the graft. The results show that endovascular repair of abdominal aortic aneurysms is an appropriate treatment for selected patients. Conversions to open repair have decreased as experience has grown; careful patient selection can minimize the number of unsuccessful implantations. Patient selection and accurate technique can also minimize the number of endoleaks.

Repetitive DNA insertion in a protein kinase ORF of a latent FSV (Feldmannia sp. virus) genome

We describe the structure of a Feldmannia sp. virus (FsV) genome integrated in the brown alga, Feldmannia. This integrated FsV genome appears to be permanently inactivated and lost its ability to excise and replicate. Unlike the replicated form of FsV, this integrated FsV genome contains a large (>50 kb) repeat region inserted in a protein kinase open reading frame. While related to the 173-bp repeats previously characterized in the FsV genome (Lee et al., 1995), Southern blot analysis indicates that the repeats in the inactive, integrated FsV genome are distinct from those previously characterized. Fine structural analysis of the repeat-insertion sites in the protein kinase gene indicates that there are 8- and 10-bp palindromic sequences present in multiple locations located near the repeat-insertion site. The translated protein kinase contains all of the catalytic motifs conserved in most serine/threonine protein kinases and a potential autophosphorylation site. This protein kinase gene is expressed as RNA in sporophyte plants where virus production is active but not in gametophyte plants where the virus genome is latent. The structure of the integrated virus genome is discussed.

Cross-cultural validity of the Eating Disorder Inventory: a study of Chinese patients with eating disorders in Hong Kong

OBJECTIVE

To evaluate the cross-cultural validity of the Chinese version of the Eating Disorder Inventory (EDI) in a clinical sample of patients with eating disorders in Hong Kong.

METHOD

After comprehensive clinical assessment, a consecutive series (1990-1996) of Chinese patients with bulimia nervosa (N = 17) and broadly diagnosed anorexia nervosa (N = 26) completed the Chinese EDI. Results were compared with those of Chinese female undergraduates (N = 606) and Canadian patients with eating disorders.

RESULTS

The EDI profiles of bulimic and fat phobic anorectic patients were remarkably and modestly similar to those of their Canadian counterparts. The EDI meaningfully distinguished bulimic patients and fat phobic anorectic patients from local undergraduates, but exhibited deficient criterion-related validity in nonfat phobic anorectic patients.

DISCUSSION

The questionable validity of certain EDI subscales in nonfat phobic patients reflects the ethnospecific constructs upon which they are based, and weakens the efficacy of the EDI in screening for anorexia nervosa in Chinese populations. Apart from illustrating some of the conceptual and methodological issues that need to be tackled in the cross-cultural study of the eating disorders, this study furnishes empirical support for the syndromal homogeneity of bulimia nervosa, and the clinical grouping of anorexia nervosa into fat phobic and nonfat phobic subtypes.

Changes in respiratory quotient elicited in rats by a conditioned stimulus predicting food

The present study examined whether changes in energy expenditure and energy substrate utilization occur in rats exposed to a conditioned stimulus that signals food. In a differential conditioning procedure, rats were given conditioning sessions where one of two cues (either a flashing light or buzzer) predicted a carbohydrate-rich meal (CS+) while the other cue predicted no food (CS-). In two subsequent test sessions, indirect calorimetry was used to measure respiratory quotient, energy expenditure, and locomotor activity before, during, and after a 15-min CS+ or CS- presentation. The CS+ was found to significantly increase respiratory quotient, indicating a shift in the energy substrate being utilized toward carbohydrate. The CS+ also increased energy expenditure and locomotor activity, but these effects were more variable across rats. It is concluded that respiratory quotient may rise in anticipation of a carbohydrate-rich meal. Possible mechanisms underlying this effect are discussed.

Rigid gas permeable contact lens fitting after radial keratotomy

PURPOSE

The purpose of our study was to determine whether radial keratotomy (RK) patients could be fit with rigid gas permeable (RGP) contact lenses based on postoperative keratometry measurements.

METHODS

Thirteen eyes from eight post-RK patients were fit with RGP lenses for residual refractive errors. Since these patients were self-referred and were operated on elsewhere, preoperative keratometry readings were not available. We used postoperative keratometry readings for base curve selection; and spherical polymethylmethacrylate diagnostic lenses were used for fitting.

RESULTS

Visual improvements averaged 3.85 Snellen lines (range: 1-8 lines). Prefitting visual acuities were: 20/30 (5 eyes); 20/40 (1 eye); 20/ 50 (1 eye); 20/60 (1 eye); 20/70 (3 eyes); 20/150 (1 eye); and 20/200 (1 eye). Final visual acuities were 20/20 (7 eyes), 20/25 (4 eyes), 20/30 (1 eye), and 20/40 (1 eye).

CONCLUSION

We found that when fitting post-RK eyes with RGP contact lenses preoperative keratometry was unnecessary, and an empirical fitting method based on postoperative keratometry was successful.

The atypical antipsychotic sertindole: a case series

BACKGROUND

Psychotic disorders are often difficult to treat with traditional neuroleptics. Sertindole is a new atypical neuroleptic with a broader CNS receptor profile.

METHOD

Ten patients diagnosed with either schizophrenia or schizoaffective disorder were treated with sertindole for 18 months and observed for changes in Clinical Global Impression scale scores.

RESULTS

Nine patients experienced a reduction of symptoms after 12 months of treatment. Eight patients completed 18 months of treatment, all exhibiting overall improvement. Despite side effects of tiredness, weight gain, headache, nausea, and decreased ejaculatory volume, sertindole was generally well tolerated.

CONCLUSION

Sertindole appears to be a useful treatment in psychotic disorders. It may present an advantage over traditional neuroleptics in the form of fewer extrapyramidal symptoms and improvement of negative symptoms.