[The psychology of being unaccounted for, based on the example of children of missing German soldiers from World War II]. / Psychologie der Vermissung am Beispiel der Kinder von Vermissten Deutschen Soldaten des Zweiten Weltkriegs.

OBJECTIVES: Despite today's extensive research on the psychosocial consequences of World War II, the group of wives and children whose husbands or fathers went "missing in action" during the Second World War, has yet to be studied systematically in Germany. The present review article shows the special role the wives, and in particular the children, of missing German soldiers played in society and discusses the impact of their loved ones being unaccounted has had on the mental health of this group. METHODS: An overview of current research on the psychosocial status of the war generation is given following a short historical introduction to the theme. Subsequently, we discuss the legal and social situation of the families of missing German soldiers during the postwar decades. Finally, two psychological concepts drawn from the US research show that specific disorders, such as complicated grief or "boundary ambiguity," can occur in the relatives of missing persons and blur the line between hope and grief occurring as a result of ambiguous loss. RESULTS AND CONCLUSION: The psychosocial impact of having a relative go missing has hardly been noticed in the German research tradition after World War II. Particularly in light of the age structure of those directly affected and the experiences of transgenerational transmission this neglected psychosocial research subject urgently needs further scientific investigation, inasmuch as the age of the family members still allows it.

Value of internal limiting membrane peeling in surgery for idiopathic macular hole stage 2 and 3: a randomised clinical trial.

AIM: To determine the effect of internal limiting membrane (ILM) peeling on anatomical and functional success rates in stage 2 and 3 idiopathic macular hole surgery (MHS). METHODS: Randomised clinical trial of stage 2 and 3 idiopathic macular hole without visible epiretinal fibrosis and with less than 1 year's duration of symptoms. Eyes were randomised to (1) vitrectomy alone without retinal surface manipulation, (2) vitrectomy plus 0.05% isotonic Indocyanine Green (ICG)-assisted ILM peeling or (3) vitrectomy plus 0.15% Trypan Blue (TB)-assisted ILM peeling. Main outcomes were hole closure after 3 and 12 months and best-corrected visual acuity after 12 months. RESULTS: 78 eyes were enrolled. Primary closure rates were significantly higher with ILM peeling than without peeling for both stage 2 holes (ICG peeling 100%, non-peeling 55%, p = 0.014) and for stage 3 holes (ICG peeling 91%, TB peeling 89%, non-peeling 36%, p<0.001). Visual outcomes in eyes with primary hole closure were not significantly different between the groups. CONCLUSIONS: Dye-assisted ILM peeling was associated with significantly higher closure rates than non-peeling in both stage 2 and 3 MHS. Intraoperative ILM staining with 0.05% isotonic ICG was not associated with a significantly different visual outcome than non-peeling or TB peeling in eyes with primary hole closure. TRIAL REGISTRATION NUMBER: NCT00302328.

NMR solution structure of dsDNA containing a bicyclic D-arabino-configured nucleotide fixed in an O4'-endo sugar conformation.

[3.2.0]bcANA is a D-arabino-configured bicyclic nucleotide with a 2'-O,3'-C-methylene bridge. We here present the high-resolution NMR structure of a [3.2.0]bcANA modified dsDNA nonamer with one modified nucleotide incorporated. NOE restraints were obtained by analysis of NOESY cross peak intensities using a full relaxation matrix approach, and subsequently these restraints were incorporated into a simulated annealing scheme for the structure determination. In addition, the furanose ring puckers of the deoxyribose moieties were determined by analysis of COSY cross peaks. The modified duplex adopts a B-like geometry with Watson-Crick base pairing in all base pairs and all glycosidic angles in the anti range. The stacking arrangement of the nucleobases appears to be unperturbed relative to the normal B-like arrangement. The 2'-O,3'-C-methylene bridge of the modified nucleotide is located at the brim of the major groove where it fits well into the B-type duplex framework. The sugar pucker of the [3.2.0]bcANA nucleotide is O4'-endo and this sugar conformation causes a change in the delta backbone angle relative to the C2'-endo deoxyribose sugar pucker. This change is absorbed locally by slight changes in the epsilon and zeta angles of the modified nucleotide. Overall, the [3.2.0]bcANA modifications fits very well into a B-like duplex framework and only small and local perturbations are observed relative to the unmodified dsDNA of identical base sequence.

Retinal detachment after cataract extraction in myopic eyes.

PURPOSE: To determine the incidence of retinal detachment (RD) after cataract extraction in people 40 years of age or older with axial myopia (i.e., axial length > or = 25.5 mm). SETTING: Fifteen Danish eye clinics. METHODS: Two hundred forty-five eyes had cataract extraction performed at 15 eye clinics; 237 eyes had extracapsular cataract extraction (ECCE) and 8 eyes, intracapsular cataract extraction (ICCE). Postoperative data were reported by the practicing ophthalmologists. Mean follow-up was 27 months (range 14 to 32 months). RESULTS: Five RDs occurred in the 245 eyes (2.0%). Excluding the ICCE cases and the two cases of combined cornea transplantation and ECCE, RD occurred in 4 of the 235 eyes that had ECCE (1.7%). The incidence after ECCE with posterior chamber lens implantation was 1.4%. Complete postoperative status was reported on 158 eyes. Forty-eight eyes (30.4%) had a neodymium:YAG capsulotomy and 3 (6.0%) developed an RD 1, 3.5, and 21 months after the capsulotomy. CONCLUSION: The RD incidence after ECCE with posterior chamber lens implantation was low but higher than that in unselected populations. The incidence increased after laser capsulotomy.

Long-term astigmatic changes after phacoemulsification with single-stitch, horizontal suture closure.

We analyzed postoperative corneal astigmatism in 32 eyes followed for three years after small incision phacoemulsification with a 4 mm scleral tunnel incision and a single-stitch, horizontal suture technique. Sutures were left intact postoperatively. Mean surgically induced cylinder was 0.63 diopters (D) at one day postoperatively, -0.01 D at one year, and -0.07 D at three years. A significant number of eyes showed an initial shift toward with-the-rule astigmatism. At one year, the axis had nearly returned to preoperative orientation without further against-the-rule shift after three years. An uncorrected visual acuity of 20/40 or better was found in 43.8% of the patients at one week postoperatively and in 62.5% at one and three years. Best corrected visual acuity of 20/40 or better was found in 62.5%, 90.6%, and 93.7%, respectively.

[Risk of cataract surgery in patients with myopia. A prospective Danish multicenter study with special reference to a complication]. / Risiko ved operation for grå staer hos naersynede. En prospektiv dansk multicenterundersøgelse med soerligt henblik på komplikationen nethindeløsning.

A prospective Danish multicentre study was conducted to evaluate the incidence of retinal detachment after cataract extraction in myopic eyes (axial length, > or = 25.5 mm). Two hundred and forty-seven cataract extractions in myopic eyes were reported during a period of 13 months. Two hundred and forty-one eyes underwent extracapsular and six eyes intracapsular cataract extraction. The mean follow-up time for 158 eyes was seven months (ranging from 1-30 months). In five cases a retinal detachment was observed, one case was probably present preoperatively, this person had undergone intracapsular cataract extraction. The incidence of retinal detachment was thus 1.62-2.02% in the total material and 1.66% in eyes operated with extracapsular cataract extraction.

Miscibility of human semisynthetic regular and lente insulin and human biosynthetic regular and NPH insulin.

The miscibility of human semisynthetic regular and lente insulins (Actrapid human/Monotard human) and human biosynthetic regular and NPH insulins (Humulin regular/Humulin NPH) was studied in vitro and in 16 insulin-dependent diabetic patients. In vitro a decrease of regular insulin was found immediately after mixture with semisynthetic lente insulin in proportions 1:4, 1:3, 1:2, 1:1, and 2:1. This was not found after mixture with human biosynthetic regular and NPH insulins. Free insulin and blood glucose were determined over 8 h after the morning injection of regular/lente (n = 9) or regular/NPH (n = 7) insulins in proportions used by the patients (approximately 1:2) mixed in one syringe or in separate syringes. Mixing the regular/lente preparations in one syringe immediately before injection resulted in a significant loss of the early rise in free insulin (P less than .01), with a tendency to a higher free insulin in the afternoon. A corresponding change in the blood glucose profile was seen. No changes were observed in free insulin or blood glucose after mixing regular and NPH preparations compared with separate injections. We conclude that mixing human semisynthetic regular and lente insulins (Actrapid human/Monotard human) instantly results in a decrease of regular insulin, probably due to formation of a longer-acting preparation, whereas no such changes occur with human biosynthetic regular and NPH insulins (Humulin regular/Humulin NPH).

Out-patient cataract surgery. First experiences from a large hospital department.

Out-patient cataract surgery was recently introduced as a routine procedure in our department. Background population, selection criteria and practical-administrative procedures for the first 33 patients are described. 19 females and 14 males, age range 45 to 90 years, were offered ambulatory surgery; 19 had extracapsular surgery and 27 intraocular lenses. Insignificant complications occurred in four cases, one of them related to the out-patient procedure. It definitely seems possible to offer this modality to selected patients without compromising medical ethics, and the results have been met with unanimous satisfaction by the patients.

Senile macular degeneration. Results of laser treatment. A preliminary report.

A preliminary report on laser treatment of senile macular degeneration is presented. Over a one year period 234 patients with symptoms and signs of macular degeneration were examined with fluorescein angiography. 32 patients (14%) showed neovascular membranes accessible to treatment with blue/green argon laser. At the end of the observation period (mean 8.7 months) one half of the treated group had unchanged or better visual acuity, whereas the other half showed deterioration of the visual acuity. It is not known whether this result differs from the average spontaneous course. A controlled trial is necessary in order to evaluate the possible beneficial effect of laser treatment of senile macular degeneration in our population.

Local application of indomethacin in healthy eyes and in post-operative cataract patients.

The effects of locally applied Indomethacin were studied. Ten healthy subjects received 1 drop of a 1% watery solution 4 times a day in their left eye during 2 weeks, the right eye serving as control. Neither changes in visual acuity and refraction nor in the appearance and function of the external and anterior segment of the eye were found during this period. Sixty-four patients underwent surgery for simple senile cataract. Half of the patients, by random selection, received Indomethacin solution locally during the first week. The remaining half received routine treatment with a compound preparation of antibiotics and corticosteroid from the third post-operative day. An inflammatory score was calculated and was found to be significantly reduced in the Indomethacin group during the first week.