Intravitreal Voriconazole for the Treatment of Cryptococcus neoformans Endogenous Endophthalmitis.

Background: Cryptococcus neoformans is an encapsulated yeast that can cause fungemia and, in rare instances, lead to endogenous fungal endophthalmitis. No standard of care has been established to treat fungal endophthalmitis when systemic antifungal treatment fails to resolve the intraocular infection. Intravitreal voriconazole has been used for the treatment of fungal endophthalmitis caused by a broad range of fungal pathogens, and a limited number of reports have shown the efficacy of using intravitreal voriconazole for C neoformans endophthalmitis. We report a case of endogenous fungal endophthalmitis caused by C neoformans that was responsive to intravitreal voriconazole. Case Report: A previously healthy 57-year-old male diagnosed with primary neuroendocrine lung tumor developed endogenous endophthalmitis from C neoformans. The endophthalmitis was resistant to intravenous amphotericin B treatment but was responsive to intravenous fluconazole in one eye and was apparently more responsive to intravitreal voriconazole in the other eye. Conclusion: Intravitreal voriconazole should be considered for the treatment of cryptococcal endophthalmitis.

Pedicled genial osteotomy modification of the mandibular release access operation for access to the back of the tongue.

We report a modification of the operation of mandibular release or 'visor drop down'. It allows more accurate repositioning and more permanent fixation of the genioglossus, geniohyoid, and digastric muscles using a small anterior osteotomy. We hope that this more accurate and reliable repositioning will give improved outcomes in terms of speech, chewing, and swallowing.

Microbial desulfurization of dibenzothiophene: a sulfur-specific pathway.

Rhodococcus rhodochrous strain IGTS8 metabolizes dibenzothiophene, a model compound for organic sulfur in fossil fuels, in a sulfur-specific manner. Two routes of desulfurization have been identified. Under growth conditions, the intermediates are dibenzothiophene sulfoxide, dibenzothiophene sulfone, 2'-hydroxybiphenyl-2-sulfonate, and 2,2'-dihydroxybiphenyl. Stationary phase cells produce 2-hydroxybiphenyl as the desulfurized product and use the 2'-hydroxybiphenyl-2-sulfinate, rather than the sulfonate, as the key intermediate.

Violating assumptions of statistical procedures: JHCM reporting guidelines.

JHCM authors have a responsibility to provide enough information for the reader to evaluate reported study conclusions and implications adequately, and to do so without overshadowing attention to statistical detail. Guidelines are presented for discussing the assumptions and requirements underlying the statistical procedures used, including what to report when there are violations.

Listening to the consumer: implications of a statewide study of North Carolinians.

To be successful in an increasingly competitive health care marketplace, physicians and other providers must understand the motives, needs, and preferences of patients and potential patients. The author reports findings from a statewide study of North Carolina consumers that provide insight into consumer awareness and utilization of various physician specialists, desirable physician practice attributes, and other regnant consumer preferences and perceptions.

The nutritional status of pregnant and non-pregnant mares grazing South East Queensland pastures.

It has been reported that the increasing nutritional demands from mid to late pregnancy of grazing mares may not be met when these stages of gestation coincide with pastures being affected by frost. It was established in this study that grass/legume pastures could support the nutritional requirements of brood mares by providing digestible energy intakes of 68.0 and 91.7 MJ/day and digestible nitrogen intake of 91.2 and 138 g/day during mid and late pregnancy, respectively.

Inhibition of brain monoamine oxidase by 1,2,4-trisubstituted 5-imidazolones.

Nine 1-(3,4-dimethoxyphenethyl)-2-methyl-4-(substituted benzylidene)-5- imidazolones were evaluated for their ability to inhibit the activity of rat brain monoamine oxidase during oxidative deamination of tyramine, 5-hydroxytryptamine (serotonin), and kynuramine. All substituted imidazolones inhibited monoamine oxidase activity. A concentration-dependent inhibition of monoamine oxidase was observed using kynuramine as the substrate and the degree of enzyme inhibition was also evaluated on the basis of their I50 values. Preincubation of imidazolones with the enzyme preparations for varying lengths of time prior to the addition of substrate in no way altered their degree of inhibition and thus exhibited a reversible nature of inhibition. A kinetic study carried out with 1-(3,4-dimethoxy-phenethyl)-2-methyl-4-(4- nitrobenzylidene )-5- i midazolone revealed a competitive nature of inhibition of rat brain monoamine oxidase.

The origins, development, and goals of adolescent medicine.

This essay offers the author's recollections and opinions on such topics as when and why an interest in adolescents' medical care originated, under what circumstances those developments occurred which preceded and soon followed the recognition of Adolescent Medicine by medical schools and hospitals, and the goals of those physicians who pursued that interest. It attempts to recount and document the events, circumstances, persons, and groups of people associated with the emergence and early development of this venture into the medical care of yet another age-group.