The association between insulin-like growth factor 1 (IGF-1), IGF-binding proteins (IGFBPs), and the carboxyterminal propeptide of type I procollagen (PICP) in pre- and postmenopausal women with rheumatoid arthritis.

OBJECTIVES: To assess the association between plasma levels of the insulin-like growth factor (IGF) system including IGF-1, IGF-binding proteins (IGFBPs) including IGFBP-1, total (t-)IGFBP-3 and functional (f-)IGFBP-3, and the carboxyterminal propeptide of type I procollagen (PICP) in pre- and postmenopausal women with rheumatoid arthritis (RA). METHOD: Plasma concentrations of IGF-1, IGFBP-1, t-IGFBP-3, f-IGFBP-3, and PICP were measured by immunoassay. RESULTS: No significant difference was observed in plasma IGF-1 levels between pre- and postmenopausal subjects. Plasma levels of IGFBP-1 were elevated in RA. PICP and f-IGFBP-3 were greatly affected by menopausal status. Of the three IGFBPs tested, only f-IGFBP-3 plasma levels in RA women correlated negatively with age and disease duration. A positive correlation was demonstrated between PICP and erythrocyte sedimentation rate (ESR) in RA. Moreover, there was no correlation between PICP and IGF-1 and any of the IGFBPs in RA women. CONCLUSIONS: Considerable disruption of the IGF system in RA was found to be related to disease activity and duration. Changes in the IGF-IGFBP axis and PICP levels were different in pre- and postmenopausal women with RA. Elevated plasma PICP concentrations may indicate an increased rate of bone formation in postmenopausal RA women. Additionally, the observed changes in the IGF/IGFBP system did not affect bone formation during RA.

Lipid peroxidation and antioxidant enzymes in synovial fluid of patients with primary and secondary osteoarthritis of the knee joint.

OBJECTIVE: Osteoarthritis of the knee (KOA) is a common, age-related, joint disorder associated with loss of articular cartilage, osteophyte formation, sub-chodral bone change and synovitis. Recent studies have shown that reactive oxygen species (ROS) may participate in the initiation and progression of KOA. This study examines potential changes in the activities of antioxidant enzymes (superoxide dismutase, both isoenzymes zinc-copper superoxide dismutase and manganese superoxide dismutase) and glutathione transformation enzymes (glutathione peroxidase, glutathione reductase and glutathione-S-transferase) in synovial fluid of KOA patients, and estimates their relationship to the degree of lipid peroxidation in synovial fluid evaluated by malondialdehyde concentration, synovial fluid viscosity, type and duration of KOA. DESIGN: Synovial fluid samples obtained by transdermal arthrocentesis from 41 patients with KOA (23 had primary KOA and 18 had secondary KOA) and 22 control subjects were analyzed. Activities of antioxidant enzymes were analysed with the use of kinetic method, MDA concentration was measured fluorometrically by the Ohkawa method, and synovial fluid viscosity was measured using a cone-late viscometer Brookfield DV-II+ and a test by Ropes. RESULTS: Patients with KOA had significantly increased activities of all enzymes when compared to the control subjects for both KOA subgroups. The synovial fluid viscosity was significantly decreased and the synovial fluid test by Ropes was abnormal in KOA patients, mainly in the secondary KOA subgroup. The activities of all antioxidant enzymes were significantly negatively correlated with synovial fluid viscosity and duration of KOA. CONCLUSIONS: Patients with KOA display abnormal antioxidant status of synovial fluid with increased activities of antioxidant enzymes and decreased synovial fluid viscosity. Furthermore, synovial fluid viscosity, and activity of GR can be used to distinguish the primary from the secondary type of KOA.

Applying signal statistical analysis to TEOAE measurements.

Automated detection of TEOAE gains increasing importance in screening applications. Conventional signal statistical analysis methods (buffer correlation and +/- difference) of TEOAE waveforms are compared with one another and with a method based on binomial statistics. It turns out that binomial statistics are more reliable and valid than conventional methods with common criteria. In particular, under narrowband noise conditions they are also faster. A frequency specific evaluation is hardly possible by means of conventional methods because of the high random correlation of narrow band signals.

Human corneal ablation threshold using the 193-nm ArF excimer laser.

PURPOSE: To determine the human corneal threshold ablation energy density for the 193-nm ArF excimer laser, approximating clinical conditions. METHODS: The VISX Star (Santa Clara, CA) 193-nm argon fluoride excimer laser was used to ablate the cornea in human eye bank eyes under clinical conditions. Corneas were exposed to energy densities of 10, 20, 30, 35, 40, 45, and 140 to 160 mJ/cm2. Corneas were fixed for light and transmission electron microscopy immediately after laser exposure. RESULTS: Different ablation thresholds for various corneal structural elements were observed. The ablation threshold for the collagen in the corneal stroma was determined to be 30 mJ/cm2. Keratocytes had ablation thresholds of 40 mJ/cm2. These different ablation thresholds accounted for the production of stromal peaks and valleys, with the keratocytes atop the peaks. CONCLUSIONS: Different corneal structural elements have different ablation threshold energy densities.

Astigmatic keratotomy effect of single-hinge, clear corneal incisions using various preincision lengths.

PURPOSE: To investigate the astigmatic keratotomy effect of a modified single-hinge cataract incision. SETTING: Department of Ophthalmology, San Juan de Dios Hospital, Tenerife, Spain. METHODS: This prospective study evaluated the astigmatic changes resulting from preincision grooves of less than 40, 45, and 55 degrees in arc length used with a single-hinge, self-sealing cataract incision in 144 eyes that had against-the-rule corneal astigmatism preoperatively. The intended 90% depth preincision was centered on the steep meridian and lengthened according to the amount of preoperative astigmatism. Outcome measurements were obtained by calculating the surgically induced astigmatism vectors and the postoperative keratometry changes 1 day, 1 week, and 1, 3, and 6 months after surgery. RESULTS: Three months postoperatively, astigmatism decreased by 0.03, 0.30, and 0.68 diopter in the less than 40, 45, and 55 degree incision length groups, respectively. The differences between the 45 and 55 degree groups and the less than 40 degree group was statistically significant (P < .05). Similar results were observed 6 months after surgery. CONCLUSION: The astigmatic preincision modification produced statistically significant increasing reductions in preoperative astigmatism according to preincision length.

["Myxoma syndrome"--a "benign" disease with "malignant" course]. / "Myxoma-Syndrom"--eine "benigne" Erkrankung mit "malignem" Krankheitsverlauf.

We are reporting on a 36 year-old woman who presented with recurrent cardiac myxomas over a period of nine years. Two of the tumors typically originated in the left atrium and one in the right atrium. Tumor embolization was the presenting symptom twice, leading to reversible cerebral ischemia and minor pulmonary embolism, respectively. The third tumor remained asymptomatic and was detected during routine echocardiographic examination. Based on a positive family history of cardiac tumors, a facially pronounced hyperpigmentation of the skin and the presence of a thyroid adenoma, the diagnosis of a "myxoma syndrome" was established. Patients with "myxoma syndrome" are generally younger than their counterparts with "sporadic myxoma" (mean age at diagnosis 25 vs. 56 years) and have a high frequency of unusual skin freckling (68%). Familial clustering of cardiac myxomas is also frequent (25%). The tumors may be located in any of the cardiac chambers (87% in the atrias, 13% in the ventricles, 50% at multiple sites simultaneously) and have relatively high (18%) 5-year recurrence rate after surgical excision. Since the clinical signs of cardiac tumors are non-specific, diagnosis essentially relies on cardiac imaging by echocardiography, computer tomography, or angiography. The superiority of transesophageal echocardiography is emphasized in this report.

[Influence of pathogenesis of purulent meningitis on the prognosis (author's transl)]. / Einflüsse der Pathogenese der Meningitis purulenta auf die Prognose

1. Where a purulent meningitis develops in association with a cyclic infectious disease (e.g. meningococcal meningitis), the prognosis is to be designated good, provided that it is diagnosed early and that no Waterhouse-Friderichsen syndrome is present and that adequate treatment is carried out. 2. In transmitted meningitis after purulent processes in the head region (sinusitis, otitis media), in addition to early diagnosis and antibiotic therapy the suppurating focus must also be cleared out in time. 3. The worst prognosis is for a purulent meningitis associated with sepsis, because here there must not only be early recognition and treatment of the meningitis, but also the recognition and treatment of the septic focus.