Diabetic retinopathy: recent advances to eliminate treatable blindness.

Recent advances in the management of diabetic retinal vascular disease are of potentially great benefit to the patient. The primary care physician plays an increasingly important and responsible role in directing patients to the care they need to help preserve their sight.

A prospective ophthalmic evaluation of patients with acute myeloid leukemia: correlation of ocular and hematologic findings.

We report the results of a prospective 2-year study of the ocular manifestations of myeloid leukemia. Fifty-three patients underwent complete ophthalmic evaluation prior to the initiation of treatment as well as during the course of their disease. All ocular abnormalities were confined to the retina and optic nerve and were present in 34 patients, 30 of whom had either hemorrhages or cotton-wool spots alone or in combination. These findings were unrelated to age, sex, French-American-British (FAB) classification, and pretreatment leukocyte count or hematocrit. Patients with retinopathy had significantly lower platelet counts than those without retinopathy. Three patients had funduscopic evidence of optic nerve edema. None of these had clinical evidence of CNS leukemia. The presence of retinopathy was unrelated to therapeutic response. There was complete resolution of all ocular findings in those patients surviving the induction phase of therapy.

Terson's syndrome. Clinicopathologic correlations.

In seven cases of Terson's syndrome, an elevated, dome-shaped, membrane was detected in the posterior pole by ophthalmoscopy, echography, or during pars plana vitrectomy. Light and electron microscopic examination of two additional eyes obtained postmortem from an acute case of Terson's syndrome revealed that the posterior vitreous face was elevated by blood and that the internal limiting membrane of the retina was intact and in its normal position. In two chronic cases, a dome-shaped epiretinal membrane was excised from the macula during vitrectomy. Light and ultrastructural studies demonstrated that the membranes consisted of glial cells and basement membrane material. The dome-shaped structure observed in eyes with Terson's syndrome is due to the formation of a subhyaloid hemorrhage. The partially detached posterior hyaloid face created by this hemorrhage provides a scaffold for cellular proliferation and the development of an elevated epiretinal membrane in long-standing cases. Echographically, this membrane resembles a retinal detachment in B-scans, but can be clearly distinguished from retina with standardized A-scan.

Involvement of opioid receptor subtypes in rat feeding behavior.

The short-acting opiate antagonist naloxone decreases food intake in three models of ingestive behavior: free feeding, food-deprivation induced feeding and deoxyglucose-induced feeding. Twenty-four hours after administration, the long-acting, mu1 selective antagonist naloxonazine inhibits food intake to the same extent as naloxone in freely feeding and food-deprived rats, but not in animals treated with 2-deoxyglucose. These results indicate that 1) opiates modulate feeding through multiple opioid receptor mechanisms, one of which is the mu subtype, and 2) the feeding observed in various experimental paradigms are modulated by different receptor subtypes. Furthermore, these results illustrate the usefulness of naloxone in defining a behavior as opioid but point out its limitations in discriminating between opioid receptor subtypes.

Moraxella bacteremia. Report of a case resembling gonococcemia with cutaneous manifestations.

A case of a Moraxella osloensis bacteremia mimicking a case of gonococcemia, complete with cutaneous manifestations, is presented. The importance of confirming all positive smears with inhibitory and noninhibitory culture media is stressed.

Synthesis of polynucleotides which contain 3,N4-ethanocytidine, a nucleoside modification resulting from the action of bis(chloroethyl)-nitrosourea.

BCNU,N,N1-bis(2-chloroethyl)-N-nitrosourea is known to produce 3-hydroxyethylcytidine and 3,N4-ethanocytidine when it reacts with polycytidylic acid. The nucleoside, 3,N4-ethanocytidine, presumably results from cyclization of 3-chloroethylcytidine formed initially by transfer of chloroethyl carboniumions from BCNU to cytidine. In order to study the significance of this unusual derivative, we have synthesized 3,N4-ethanocytidine and converted it to the corresponding 5'-mono- and diphosphates. 3,N4-Ethanocytidine diphosphate has been successfully converted to a high molecular weight polymer.