The prevalence of bacteraemia-related retinal lesions in seriously ill patients

OBJECTIVES

In this study, we investigated the frequency and aetiology of retinal lesions in bacteraemic and septic patients and the risk factors involved.

METHODS

A total of 150 adult patients in our hospital were included in the study. After consultation with the infectious diseases specialist, the following details were recorded: demographic data, area of admission, underlying diseases, Winston's clinical condition, Charlson's co-morbidity index, McCabe's criteria for underlying disease, APACHE II scoring, community or nosocomial acquisition of bacteraemia, and micro-organism responsible. Blood cultures were obtained from all the patients at least three times. All patients were examined for ocular lesions by the same ophthalmologist 48-72 h after the first examination. Some long-term hospitalized patients were evaluated more than once.

RESULTS

Patients were divided into six groups: 18 (12%) were bacteraemic non-septic; 31 (20.7%) were septic bacteraemic; 43 (28.7%) were septic non-bacteraemic; 19 (12.7%) had systemic inflammatory response syndrome (SIRS); 16 (10.7%) were non-septic non-bacteraemic but infectious; and 23 (15.3%) were controls. We found bacteraemia-related retinal lesions (BRRLs) in 22/150 (14.7%) of the patients, 19 of whom (86.4%) were in the septic-bacteraemic group while 3 (13.6%) were in the septic non-bacteraemic group. BRRLs were observed in 19/31 (61.3%) patients in the septic-bacteraemic group. Winston and APACHE II scores were found to be higher in patients with BRRLs than in others. BRRLs were more prevalent in septic or bacteraemic patients with central nervous system (CNS) diseases (31.8%) or cancer (27.3%) than in patients with other diseases. The organism most frequently responsible for bacteraemia in patients with BRRLs was Pseudomonas aeruginosa (27.3%), and the second most common was Staphylococcus aureus (22.7%).

CONCLUSION

BRRLs are most frequent in bacteraemic-septic patients (61.3%). The underlying diseases predisposing most to BRRLs are diseases of the CNS and cancers. Ocular examination appears to be a useful aid to diagnosis of bacteraemia or sepsis.

Brief intervention on maternal smoking: a randomized controlled trial

OBJECTIVES

To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than mothers who received routine smoking cessation advice, which focused on their own health, or a control group of mothers.

SETTING

Tertiary referral centre.

METHODS

Randomized control trial. A total of 363 mothers were randomly assigned to a smoking cessation intervention either aimed at their children's health (n = 111) or their own health (n = 131), or to a control group receiving no smoking cessation advice (n = 121).

RESULTS

Provision to mothers of both groups of health risks of tobacco smoke resulted in significantly higher rate of cessation of smoking and smoking location change than those of the control group, with child intervention group having significantly higher rate of cessation of smoking and smoking location change than those of the maternal intervention group (P < 0.05). Post-intervention knowledge scores differed significantly for all groups; however, child intervention group was the only significantly better group than the others (P < 0.05). According to the multivariate analysis results, intervention grouping and presence of smoking friends were independent factors determining smoking cessation (P < 0.05). Intervention grouping, post-intervention knowledge, presence of other household members who smoked and family income were independent factors determining smoking location change (P < 0.05). Family income, intervention grouping and presence of smoking friends were significant independent factors influencing post-intervention knowledge (P < 0.05).

CONCLUSION

Discussion during short paediatric visits on effects of smoking on child's or maternal health may result in a significant smoking cessation, smoking location change rate or knowledge change. Those who cannot give up smoking usually change their location of smoking. Provision of information on effects of smoking on child's health, rather than maternal, may result in more significant changes in behaviour or knowledge. Maternal education on smoking should include information on effects of smoking on both child's and maternal health, but should be especially focused on child's health.

Leptin in corneas from keratoconus and infectious keratitis patients

PURPOSE

Leptin is produced primarily by adipose tissue. More recent studies have shown extra sites of leptin production in physiologic and ill human tissues. However, whether leptin originates from human corneas in infectious keratitis and keratoconus is not known. The aim of this study was to demonstrate and quantitate leptin expression in corneas with infectious keratitis and keratoconus and make comparisons to control corneas.

METHODS

We examined the immunohistochemical staining of leptin in nine corneas surgically excised from patients with infectious keratitis (3 patients), keratoconus (3 patients), and donor corneas (3 patients).

RESULTS

The results were analyzed using a semiquantitative scoring system of mild, moderate, and strong. Cells of the infectious keratitis group had the strongest leptin staining intensity, the control group had moderate, and the keratoconus group had mild staining intensity. The more vascular corneas in the infectious keratitis group were also associated with the greatest leptin staining.

CONCLUSIONS

Our findings indicate that leptin expression was present in all three sources of corneas (infectious keratitis, keratoconus, and normal control). Quantitative scoring would imply it may play a role in infectious keratitis, although further experiments are necessary to establish any causal relationship.

Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study

OBJECTIVE

Strict metabolic control during the 1st year of type 1 diabetes is thought to be a key factor for achieving clinical remission. The aims of this study were two-fold: (i) to evaluate the frequency and duration of spontaneous remission (defined according to the parameters issued by the International Diabetic Immunotherapy Group (IDIG)) in a European population of consecutive recent onset type 1 diabetes patients (aged 5-35 years), followed-up for a period of 36 months with a common protocol of intensive insulin therapy and without adjunct immune-intervention; and (ii) to identify the predictive factors for clinical remission.

RESEARCH DESIGN AND METHOD

A total of 189 consecutive patients with newly diagnosed type 1 diabetes according to ADA criteria were recruited in participating centres (Belgium, Czech Republic, Estonia, France, Germany, Hungary, Italy, Poland, Romania, Sweden and Turkey) and followed-up for a period of up to 36 months. In all patients, intensive insulin therapy was implemented consisting of three or four injections of regular insulin daily with NPH insulin at bedtime. Adjustment of insulin dose was made according to a common protocol. Various clinical characteristics (age, gender, severity of presentation, etc.), history (presence of diabetic siblings in the family, etc.) and integrated parameters of metabolic control (HbA(1c), blood glucose, the total insulin dose at hospital discharge adjusted for body weight) were collected.

RESULTS

Twenty-two patients (11.6%) experienced remission. The median duration of remission was 9.6 months and the range was 31 months. There was a wide variation among centres. Logistic regression analysis focused on the centre as the main variable in achieving remission.

CONCLUSION

Remission was shown to be very heterogeneous between centres depending on 'other factors' such as patient care and family awareness of the disease rather than on 'measurable factors' such as sex, age, HbA(1c) and severity of presentation at diagnosis. Using intensive insulin therapy and optimisation of metabolic control, remission occurred in nearly one out of eight patients.

Moderate Exercise Combined with Dietary Vitamins C and E Counteracts Oxidative Stress in the Kidney and Lens of Streptozotocin-induced Diabetic Rat

Oxidative stress has a key role in the pathogenesis of diabetes-induced cataract formation and nephropathy. Daily moderate exercise and vitamins C and E (VCE) supplementation can be beneficial to diabetes due to reducing blood glucose and free radical production The aim of this study was to analyze the effect of moderate exercise with vitamin VCE on lipid peroxidation (LP) and antioxidative systems in the kidneys and lens of streptozotocin-induced diabetic rats. Forty female Wistar rats were used. They were randomly divided into four groups. The first and second groups were used as control and diabetic groups. The third group was the diabetic-exercise group. VCE-supplemented feed was given to diabetic-exercise rats constituting the fourth group. Animals in the exercised groups were moderately exercised daily on a treadmill for three weeks (five days a week). Diabetes was induced on day zero of exercise. Body weights in the four groups were recorded weekly. Lens and kidney samples were taken from all animals on day 20. Glutathione peroxidase (GSH-Px), reduced glutathione (GSH), vitamin E, and β-carotene levels in kidney and lens, albumin in plasma, and body weight were significantly lower in the diabetic group than in the control group, whereas there was a significant increase in LP of kidney and lens as well as plasma glucose, urea, and creatinine levels in the diabetic group. The decrease in antioxidant enzymes, vitamins, and albumin and the increase in LP and glucose levels in diabetic rats were significantly improved with exercise and VCE supplementation. In the diabetic animals, the decreased β-carotene and vitamins A levels in kidney did not improve through exercise only, although their levels were increased by exercise plus VCE supplementation. In conclusion, these data demonstrate that lipid peroxidation increases in the lens and kidney of diabetic animals and this could be due to decreases in antioxidant vitamins and enzymes. However, dietary VCE with moderate exercise may strengthen the antioxidant defense system through the reduction of ROS and blood glucose levels. The VCE supplementations with exercise may play a role in preventing the development of diabetic nephropathy and cataract formation in diabetic animals.

A case of mumps conjunctivitis: detection of the virus RNA by nested PCR in tear sample

Mumps is a disease caused by a virus that can infect many parts of the body, especially the parotid salivary glands. A case of epidemic parotitis in an adult female affected by bilateral conjunctivitis is presented. Mumps virus was detected in tear samples by reverse transcription nested polymerase chain reaction (RT-n-PCR). The conjunctivitis resolved completely within 11 d.

Administration of high dose intravitreal melatonin degenerates retinal cells in guinea pigs

The purpose of this study was to investigate the influence of intravitreally injected different doses of melatonin on retinal morphology. The right eyes of 35 male albino guinea pigs were used. The animals were classified randomly into five groups in equal numbers. First group was used as control and received intravitreal injection of placebo. Groups 2, 3, 4 and 5 received intravitreally injections of melatonin at 50, 100, 150 and 200microg/body weight (BW) each, respectively. The animals were sacrificed 15 days after the injections. The eyes were enucleated and processed for light microscopic evaluation. Intravitreal injection of melatonin at doses ranging from 50 to 150microg did not induce morphological changes, although a higher thickness of the inner plexiform layer (IPL) was found in Group 5 compared to other groups (p < 0.05). The mean retinal ganglion cell (RGC) counts were found to be lower in Group 5 compared to other groups (p < 0.05). Our findings indicate that intravitreal injection of melatonin at doses ranging from 50 to 150microg/BW does not induce morphological changes. The dose of 200microg/BW produced significant damage including retinal ganglion cell loss and formation of retinal edema.

[Ganglion cysts of the knee originating from tendons and ligaments]

PURPOSE

To investigate the clinical features and MR imaging findings of the ganglion cysts arising from the tendons and ligaments of the knee.

MATERIALS AND METHODS

One thousand six hundred and twenty knee MR examinations that had been performed in a three-year period were evaluated retrospectively for the presence of ganglion cysts originating from tendons or ligaments. Clinical findings and MRI features of the lesions were noted.

RESULTS

Twenty-three patients had a ganglion cyst originating from a tendon or a ganglion, with an incidence of 1.4%. Six lesions were associated with the anterior cruciate ligament, six with the posterior cruciate ligament, six with the medial collateral ligament, two with the lateral collateral ligament, two with the transverse ligament, and one with the patellar tendon. The most common clinical finding was knee pain. There were swelling at the medial side of the knee in two patients, swelling at the lateral side of the knee in one patient and swelling in the popliteal region in one patient.

CONCLUSION

MR appearance of ganglion cysts arising from the tendons and ligaments of the knee is characteristic. Meniscal cysts, pigmented villonodular synovitis, and synovial hemangioma should be considered in the differential diagnosis.

Evaluation of gustatory function after third molar removal

The aim of this study was to determine the severity of taste changes after surgical removal of all four third molars in one session. Taste function in 27 patients was measured before and at 1 month and 6 months after surgery. In every patient all four third molars were removed using local anesthesia and sedation with midazolam and fentanyl. For testing gustatory function, two tests were administered: a whole-mouth, above threshold test and a spatial (localized) taste test. For this purpose, sucrose, NaCl, citric acid and quinine hydrochloride solutions were used. Taste intensity of quinine hydrochloride of the palate was significantly reduced 1 month after surgery (P < 0.05) but recovered and reach to preoperative values 6 months after surgery. The results showed that there were no significant changes in gustatory function after third molar surgery.

Protective effects of intraperitoneal vitamin C, aprotinin and melatonin administration on retinal edema during experimental uveitis in the guinea pig

A considerable amount of clinical and experimental evidence exists suggesting the involvement of reactive oxygen substances (ROS) in the aetiology of uveitis. The activated phagocytic system of polymorphonuclear leucocytes in uveitis is involved in the generation of ROS. In addition to their direct free radical scavenging action, aprotinin, melatonin and vitamin C are known to protect against oedema formation and can preserve plasma membrane fluidity and free radical production. Histological changes in the retina that occur during uveitis are not well explained. The purpose of this study was to determine whether vitamin C, aprotinin and melatonin can protect the retina from damage accompanying experimental uveitis (EU). Thirty adult male guinea pigs were divided into five groups of six animals each. The first group was used as control. The right eyes of groups 2, 3, 4 and 5 received an intravitreal injection of bovine serum albumin for induction of experimental uveitis. At the same time and also on the consecutive third day, groups 3, 4 and 5 received intraperitoneal injections of vitamin C (ascorbic acid, 100 mg kg(-1) body wt), aprotinin (20,000 kIU kg(-1) body wt) and melatonin (10 mg kg(-1) body wt), respectively. The animals were killed on the sixth day. The average thickness of the retina and inner plexiform layer for each eye was measured in sagittal section near the optic nerve and expressed in microns. The thickness of the retina and inner plexiform layer in the control group was significantly (p < 0.01) lower than in the group EU as compared with the group EU plus vitamin C, group EU plus aprotinin, group EU plus melatonin (p < 0.05). The thicknesses of the retina and inner plexiform layer in group EU plus vitamin C, group EU plus aprotinin and group EU plus melatonin were significantly (p < 0.01) lower than that in the group EU. The difference in thickness of the retina and inner plexiform layer among the groups 3, 4 and 5 was not significant (p > 0.05). In conclusion, this study demonstrated that oedematous effects of EU on the retina were reduced by the administration of intraperitoneal vitamin C, aprotinin and melatonin, i.e. these antioxidants had significant protective effects on the retina of guinea pigs against oedematous damage in EU. However, the reductive effect of vitamin C on EU was greater than that of aprotinin and melatonin. The intraperitoneal vitamin C, aprotinin and melatonin supplementations may strengthen the antioxidant defence system because of decreased ROS, and these agents may play a role in treating uveitis.

A Neurofuzzy Classification System for the Effects of Diabetes Mellitus on Ophthalmic Artery

Here, we present a classification system for the effects of diabetes mellitus (DM) on blood flow hemodynamics of the ophthalmic arteries by using neurofuzzy system. Blood flow hemodynamics were obtained from 80 ophthalmic arteries of 20 healthy persons and 20 patients with DM by using 7.5 MHz transducer and Doppler-M unit. Peak systole, peak diastole, resistive index (RI), pulsatile index (PI), and systole/diastole rate (SDR) were measured with the use of Doppler sonography. These values were applied to neurofuzzy system using NEFCLASS model. The performance of this classification system was examined with the application of the data obtained from Doppler analyses of the right and left ophthalmic arteries to the neurofuzzy system. After learning and testing processes, 85% success rates were reached from the data of right ophthalmic arteries, and 87.5% success rates were reached from the data of left ophthalmic arteries. Our findings suggest that neurofuzzy system may provide a successful classification system for the effects of DM on either right or left ophthalmic arteries with the application of Doppler signal parameters from carotid arteries to neurofuzzy system may produce a new and reliable classification system for diagnosing diameter stenosis.

Pigmented Paravenous Retinochoroidal Atrophy

Seven patients (4 men and 3 women, ranging in age from 27 to 64 years) with pigmented paravenous retinochoroidal atrophy, a rare disorder of unknown origin, were studied. The mean follow-up time was 18.5 months. Fundus examinations were performed, and color fundus photographs were taken. In addition to fluorescein angiography, visual field examinations, color vision and electroretinographic tests were performed. All 7 patients were asymptomatic, with visual acuities ranging from 3/10 to 10/10. Both fundi showed patches of retinochoroidal atrophy and pigmentation along the retinal veins in all patients. Fluorescein angiography showed hyperfluorescence due to the pigment epithelial atrophy together with hypofluorescence corresponding to bone spicule pigment clumping. Visual field tests showed scotomas corresponding with areas of atrophy along the retinal veins. The electroretinography showed reduced responses in 2 cases. Color vision was normal in all cases. The patients had no history of trauma or a previous inflammatory process. Serology for syphilis, Toxoplasma and cytomegalovirus as well as a skin test for tuberculosis were negative. When the patients were seen at the end of the follow-up period, no variation of the findings was noted. Although the fundus abnormalities can be mild or severe, retinal function tests indicated that this is a geographic and not a generalized disorder.

[Case report: MRI findings in gout]

MR imaging is not routinely used for the evaluation of tophaceous gout. However, gout may have atypical clinical and radiologic findings. It should be considered in the differential diagnosis when a mass reveals heterogeneous and low signal intensity on T2 weighted images. We present MR imaging characteristics of gout tophi and arthritis in two patients.

Persistent stapedial artery: MR angiographic and CT findings

A 2-year-old girl was found to have a pink pulsatile mass behind the right tympanic membrane on physical examination. We report the high-resolution CT and MR angiographic findings of persistent stapedial artery with hypoplasia of the A1 segment of the right anterior cerebral artery.

Evaluation of gustatory function in postmenopausal women

OBJECTIVE

The aim of this study is to evaluate the gustatory function in postmenopausal women.

SUBJECTS AND METHODS

Whole mouth taste test and spatial taste test were administered to 20 postmenopausal women (Group 1) and 20 age-matched male subjects (Group 2). Further investigations were carried out for subjective assessment of taste alteration and nutritional differences between premenopausal and postmenopausal periods.

RESULTS

There was a significant reduction in sucrose perception and in palatal sensitivity in postmenopausal women (p<0.05). Only 7(35%) of the female patients noticed alteration in taste perception during the postmenopausal period. Alteration in dietary habits after menopause was reported by 9 (45%) patients.

CONCLUSION

This study demonstrates that taste perception of the tongue does not change, but that there is a disorder in palatal perception in postmenopausal women. Furthermore, there is tendency to preference of sweeter foods during menopause.

The protective effects of melatonin, vitamin E and octreotide on retinal edema during ischemia-reperfusion in the guinea pig retina

PURPOSE

The purpose of this study is to provide evidence that free radical damage is a component of retinal ischemia-reperfusion (I/R) injury, and to determine whether melatonin, vitamin E and octreotide can protect retina from this injury.

METHODS

The right eyes of 50 male guinea pigs weighing 500-600 g were used. The animals were randomly assigned to group 1 (control), group 2 (I/R), group 3 (melatonin + I/R), group 4 (vitamin E + I/R) and group 5 (octreotide + I/R). Groups 3, 4 and 5 received four subcutaneous injections at six-hour intervals for total dosage of 10 mg/kg melatonin, 150 mg/kg vitamin E and 22 microg/kg octreotide respectively. The first dose of each substance was administered 5 minutes before retinal ischemia. Retinal ischemia was induced for 1.5 hours, then followed by reperfusion for 24 hours. Infections of all three substances were repeated at 6, 12 and 18 hours during reperfusion. The animals were killed at 24 hours of reperfusion. Sagittal sections of 4 microm were cut and stained with hematoxylin and eosin for light microscopic evaluation. The average thickness (edema) of the inner plexiform layer for each eye was measured in sagittal sections near the optic nerve and expressed in microns.

RESULTS

The efficacy of each compound had the following relationships: melatonin>vitamin E>octreotide in preventing retinal damage by ischemia-reperfusion. The mean thickness of the inner plexiform layer was 13.3 +/- 0.8 microm, 25.9 +/- 2. 0 microm, 20.0 +/- 0. 7 microm, 21.6 +/- 0.7 microm, 23.9 +/- 0.8 microm respectively in the control, I/R, I/R plus melatonin, I/R plus vitamin E and I/R plus octreotide groups. The thickness of the inner plexiform layer in group 1 (control) was significantly less than the other groups (p<0.001). The inner plexiform layer was thicker in the I/R group than with I/R plus melatonin, I/R plus vitamin E and I/R plus octreotide (all p < 0.01). The inner plexiform layer was thicker in the I/R plus octreotide group than the I/R plus vitamin E and I.R plus melatonin groups both (p < 0.05). Compared to the I/R plus melatonin group, the inner plexiform layer was significantly thicker in the I/R plus vitamin E group (p < 0. 05).

CONCLUSIONS

This study demonstrates a protective effect of melatonin, vitamin E and octreotide on the retina during retinal ischemia-reperfusion injury.

CT findings of abdominal tuberculosis in 12 patients

Our purpose was to evaluate the Computed Tomography (CT) findings of the abdominal tuberculosis (TBC) retrospectively which was diagnosed histopatologically. This study included 12 patients. All patients were evaluated by abdominal CT study. Most findings of CT studies were mesenteric calcified or noncalcified lymphadenopathies, ascites, thickened intestinal wall located on the right lower quadrant of abdomen, thickening of peritoneum, mottled soft-tissue densities in omentum and mesenterium. In addition, one of the patients had bilateral calcified adrenal glands and one of them had calcified mass in adrenal gland. If peritoneal thickening, ascites, abdominal lymphadenophaties and thickened intestinal walls are obtained, TBC should be considered in differential diagnosis in developing countries.

Measurement of residual phase noise and longitudinal-mode linewidth in a hybridly mode-locked external linear cavity semiconductor laser

We report measurements of the residual phase-noise knee position and longitudinal-mode linewidth of a hybridly mode-locked external linear cavity semiconductor laser as a function of laser cavity length. Excellent agreement between these measurements suggests a direct relationship between rms pulse-to-pulse timing jitter and average longitudinal-mode linewidth. This relationship leads to a fundamental limit in the timing jitter of mode-locked lasers.

Ultralow noise and supermode suppression in an actively mode-locked external-cavity semiconductor diode ring laser

We report what is to our knowledge the lowest phase and amplitude noise characteristics achieved to date in a 10-GHz pulse train produced by the active harmonic mode locking of an external-cavity semiconductor diode laser. Supermode noise has also been suppressed below -140 dBc/Hz by use of a high-finesse fiber Fabry-Perot etalon as an intracavity filter. Novel noise sideband measurements that extend to the Nyquist offset frequency suggest a significant advantage in using harmonic (rather than fundamental) mode locking to produce ultralow-noise pulse trains, owing to the relationship between the noise roll-off frequency and the fundamental cavity frequency.

The use of waterworks sludge for the treatment of dye wastes

Water treatment works using coagulation/flocculation in the process stream will generate a waste sludge. The works in Adana, Turkey uses ferric chloride. The potential for using this sludge for the treatment of reactive, direct, disperse, acidic, and basic dyestuffs by coagulation and sorption has been investigated. The sludge acted as a coagulant and removed colour with excellent removal efficiencies being obtained for basic, disperse and direct dyes. The optimum conditions were a pH value of 5 and a sludge dose of 2000 mg l(-1). Mediocre results were obtained for acidic and reactive dyes. The efficiency of the sludge was also compared with alum and ferric chloride for the same group of dyes. The sludge was also used as a coagulant to treat the wastewater from a textile factory. At doses of 2000-4000 mg l(-1), the sludge was as effective as ferric chloride and alum at removing COD. Sorption tests showed that the disperse and reactive dyes did not bind to the sludge. Langmuir and Freundlich constants were determined for the other three types of dye. Rate constants for the adsorption were determined using the Lagergren equation.

Effects of melatonin, vitamin E and octreotide on lipid peroxidation during ischemia-reperfusion in the guinea pig retina

PURPOSE

The purpose of this study is to provide evidence that free radical damage is a component of retinal ischemia-reperfusion (I/R) injury, and to determine whether melatonin, vitamin E and octreotide can protect the retina from this injury.

METHODS

The right eyes of 50 male guinea pigs weighing 500-600 g were used. The animals were randomly assigned to group 1 (control), group 2 (I/R), group 3 (melatonin + I/R), group 4 (vitamin E + I/R) and group 5 (octreotide + I/R). Groups 3, 4 and 5 received four subcutaneous injections with a 6-h interval for a total daily dose of 10 mg/kg melatonin, 150 mg/kg vitamin E and 22 microg/kg octreotide. The first dose of each substance was administered 5 minutes before retinal ischemia, which was induced for 1.5 hours, followed by reperfusion for 24 hours. All three substances were repeated for 6, 12 and 18 hours during reperfusion. The animals were killed at 24 hours of reperfusion. Retinas were isolated and processed for the quantification of malondialdehyde (MDA).

RESULTS

The compounds had the following relationships: melatonin more than vitamin E more than octreotide in preventing retinal damage by ischemia-reperfusion. All three gave significantprotection against the formation of MDA (10.4+/-2.3, 12.4+/-2.4, 13.9+/-1.5 nmol/100 mg tissue wet weight, respectively) compared to the control (3.7+/-1.3 nmol/100 mg tissue wet weight) and I/R groups (22.7+/-6.2 nmol/100 mg tissue wet weight).

CONCLUSIONS

This study demonstrates the inhibitory effect of melatonin, vitamin E and octreotide on MDA levels during retinal ischemia-reperfusion injury.

Bcl-2 and LMP1 expression in nasopharyngeal carcinomas

In vitro studies of B-cells immortalized by Epstein-Barr Virus (EBV) have shown that B-cell leukemia/lymphoma-2 (bcl-2) protein expression is upregulated by the EBV-latency-associated antigen, latent membrane protein 1 (LMP1). The same phenomenon has also been observed in epithelial cells in vitro. However, such correlation between these 2 markers has not been shown in nasopharyngeal carcinoma (NPC), in which EBV infection is a well-known etiologic factor. This retrospective study examined 35 cases of undifferentiated NPC to answer the question of whether LMP1 and/or bcl-2 presence can be used as biomarkers at treatment response, as well as to see the relationship between bcl-2 and LMP in NPC. Of the 35 patients, 26 (74.3%) were bcl-2, and 10 (28.6%) were LMP1-positive. Although a significant correlation was observed between bcl-2 and LMP1 staining (P =.003), it appeared that bcl-2 expression could be independent of LMP1. Statistical analysis showed that cervical lymph node metastasis (P =.04) and cranial nerve involvement (P =.03) are the only variables that significantly affect patient survival. At this time, bcl-2 and LMP1 presence are not significant indicators of outcome; however, although they are not directly related to survival, expression of both bcl-2 and LMP1 was strongly correlated with cervical lymph node metastasis, which is a potent predictor of patient survival.

The effect of carnitine on random-pattern flap survival in rats

Carnitine is an endogenous cofactor involved in the transport of long-chain fatty acids into the mitochondria where they undergo beta-oxidation. Through another reaction, carnitine produces free coenzyme A and reduces the ratio of acetyl-coenzyme A to coenzyme A, thereby enhancing oxidative use of glucose, augmenting adenosine triphosphate synthesis, and reducing lactate production and acidosis. Because of its regulatory action on the energy flow from the different oxidative sources, especially under ischemic conditions, carnitine has been used in cardiovascular diseases such as coronary heart disease, congestive heart failure, peripheral vascular disease, dyslipidemia, diabetes, and chronic renal diseases with satisfactory results. A flap is also a relatively ischemic tissue and may obtain benefit from carnitine. To investigate this, 30 rats were divided into three groups of 10 animals: a control group and two carnitine-treated groups. Random dorsal skin flaps were elevated on the rats. In the control group, no pharmacologic agents were used. Of the two treated groups, group 1 was treated with 50 mg/kg/day carnitine for 1 week and group 2 was treated with 100 mg/kg/day carnitine for 1 week. The areas of flap necrosis were measured in each group. The median areas of flap necrosis of the groups were 12.55, 9.23, and 4.9 cm2, respectively. There was a statistically significant improvement of flap necrosis in carnitine-treated groups compared with the control group (group 2, p = 0.001; group 3, p = 0.000). Furthermore, there was less necrosis in the high-dose carnitine-treated group than the low-dose carnitine-treated group. As a conclusion, carnitine may have a dose-dependent effect to increase flap survival in random skin flaps.