Growth mechanism of nano-plates structured SnS films on different substrates in glancing angle deposition method.

In this work, Tin (II) sulfide films have been deposited on glass, Indium Tin Oxide, and Fluorinated Tin Oxide substrates at the deposition angles of 0º, 65º, and 85º using Physical Vapor Deposition method equipped with Glancing Angle Deposition technique. Based on the results obtained from the X-ray diffraction technique, the crystalline structure of substrates and the angle of depositions along with their effects on the structure of SnS nano-plates have been investigated. Using Raman analysis, the phonons lifetime of the samples was found to change with the type of substrate and the employed deposition angle. Based Energy-dispersive X-ray spectroscopy analysis, the atomic ratio of Sn to S was observed to change with the change of deposition angle, substrate type and variation the diameter of nano-plates. This phenomenon resulted the formation of the second phase of Sn2S3 which was confirmed by Raman and X-ray diffraction patterns. The nano-sheets-like growth of all the samples has been confirmed using Felid Emission Scanning Electron Microscopy analysis. For further morphological studies, the Atomic Force Microscopy analysis has been applied, by which the direct relation between the substrate roughness and the final structure of the samples has been observed. The relation between the substrate roughness and the deposition angle in the growth process of SnS nano-sheets has been explained.

Enhancement of Toxic Substances Clearance from Blood Equvalent Solution and Human Whole Blood through High Flux Dialyzer by 1 MHz Ultrasound.

BACKGROUND: Hemodialysis is a process of removing waste and excess fluid from blood when kidneys cannot function efficiently. It often involves diverting blood to the filter of the dialysis machin to be cleared of toxic substances. Fouling of pores in dialysis membrane caused by adhesion of plasma protein and other toxins will reduce the efficacy of the filtre. OBJECTIVE: In This study, the influence of pulsed ultrasound waves on diffusion and the prevention of fouling in the filter membrane were investigated. MATERIAL AND METHODS: Pulsed ultrasound waves with frequency of 1 MHz at an intensity of 1 W/cm2 was applied to the high flux (PES 130) filter. Blood and blood equivalent solutions were passed through the filter in separate experimental setups. The amount of Creatinine, Urea and Inulin cleared from both blood equvalent solution and human whole blood passed through High Flux (PES 130) filter were measured in the presence and absence of ultrasound irradiation. Samples were taken from the outlet of the dialyzer every five minutes and the clearance of each constituent was calculated. RESULTS: Statistical analysis of the blood equvalent solution and whole blood indicated the clearance of Urea and Inulin in the presence of ultrasound increased (p<0.05), while no significant effects were observed for Creatinine. CONCLUSION: It may be concluded that ultrasound, as a mechanical force, can increase the rate of clearance of some toxins (such as middle and large molecules) in the hemodialysis process.

Photo neutron dose equivalent rate in 15 MV X-ray beam from a Siemens Primus Linac.

Fast and thermal neutron fluence rates from a 15 MV X-ray beams of a Siemens Primus Linac were measured using bare and moderated BF3 proportional counter inside the treatment room at different locations. Fluence rate values were converted to dose equivalent rate (DER) utilizing conversion factors of American Association of Physicist in Medicine's (AAPM) report number 19. For thermal neutrons, maximum and minimum DERs were 3.46 × 10(-6) (3 m from isocenter in +Y direction, 0 × 0 field size) and 8.36 × 10(-8) Sv/min (in maze, 40 × 40 field size), respectively. For fast neutrons, maximum DERs using 9" and 3" moderators were 1.6 × 10(-5) and 1.74 × 10(-5) Sv/min (2 m from isocenter in +Y direction, 0 × 0 field size), respectively. By changing the field size, the variation in thermal neutron DER was more than the fast neutron DER and the changes in fast neutron DER were not significant in the bunker except inside the radiation field. This study showed that at all points and distances, by decreasing field size of the beam, thermal and fast neutron DER increases and the number of thermal neutrons is more than fast neutrons.

Three-dimensional Imaging Reveals New Compartments and Structural Adaptations in Odontoblasts.

In organized tissues, the precise geometry and the overall shape are critical for the specialized functions that the cells carry out. Odontoblasts are major matrix-producing cells of the tooth and have also been suggested to participate in sensory transmission. However, refined morphologic data on these important cells are limited, which hampers the analysis and understanding of their cellular functions. We took advantage of fluorescent color-coding genetic tracing to visualize and reconstruct in 3 dimensions single odontoblasts, pulp cells, and their assemblages. Our results show distinct structural features and compartments of odontoblasts at different stages of maturation, with regard to overall cellular shape, formation of the main process, orientation, and matrix deposition. We demonstrate previously unanticipated contacts between the processes of pulp cells and odontoblasts. All reported data are related to mouse incisor tooth. We also show that odontoblasts express TRPM5 and Piezo2 ion channels. Piezo2 is expressed ubiquitously, while TRPM5 is asymmetrically distributed with distinct localization to regions proximal to and within odontoblast processes.

Phase I study of continuous afatinib (BIBW 2992) in patients with advanced non-small cell lung cancer after prior chemotherapy/erlotinib/gefitinib (LUX-Lung 4).

PURPOSE: This Phase I study determined the maximum-tolerated dose (MTD) of afatinib (Afatinib is an investigational compound and its safety and efficacy have not yet been established) (BIBW 2992; trade name not yet approved by FDA), an irreversible inhibitor of epidermal growth factor receptor (EGFR)/human epidermal growth factor receptor (HER)1 and 2, up to a dose of 50 mg/day in advanced non-small cell lung cancer (NSCLC), to establish the recommended dose for Phase II. METHODS: Patients with advanced NSCLC who had received prior platinum-doublet chemotherapy and/or erlotinib/gefitinib therapy, or who were ineligible for, or not amenable to, treatment with established therapies, received oral afatinib once daily. The MTD was determined based on dose-limiting toxicities (DLTs); other assessments included safety, pharmacokinetic profile, antitumour activity according to response evaluation criteria in solid tumours and EGFR/HER1 mutation analysis where possible. RESULTS: Twelve evaluable patients were treated at doses of 20-50 mg/day. One DLT was observed at 50 mg/day in Course 1 (Grade 3 mucositis). The most frequent drug-related adverse events were diarrhoea, dry skin, stomatitis, rash, paronychia and anorexia; most were Grade 1 or 2. Six out of 12 patients had tumour size reductions; durable stable disease was achieved in three patients including one with EGFR/HER1 exon 19 and T790 M mutations. Peak plasma concentrations of afatinib were reached 3-4 h after administration and declined with a half-life of 30-40 h. Afatinib 50 mg/day was well tolerated with an acceptable safety profile during Phase I. CONCLUSION: Recommended dose for Phase II was defined as 50 mg/day for Japanese patients; the same as for non-Japanese patients.

The relationship between macular cell layer thickness and visual function in different stages of glaucoma.

PURPOSE: To determine whether there were differences in the structure-function relationship between early and advanced glaucoma, and study the association between thickness of discrete macular cell layers, the thickness of the retinal nerve fiber layer, and visual field sensitivity. METHODS: In all, 71 eyes of 50 subjects (28 glaucoma patients and 22 normal control subjects) were included. Thickness of macular retinal nerve fiber layer (mRNFL), macular inner retinal layer (mIRL), and macular outer retinal layer (mORL) were measured from Stratus optical coherence tomography macular scans, using our previously published segmentation algorithm. Visual sensitivity loss was determined by mean deviation (MD) using Humphrey Visual Field Analyzer. The mean thickness for each layer from the normal control subjects, early, and advanced glaucoma groups was compared. In addition, a mixed model analysis was used to explore the relationship between structure-function, allowing for possible interaction with glaucoma stage. RESULTS: The mean mRNFL thickness in early and advanced glaucoma patients was significantly less than measurements in normal subjects (P<0.01). The mean mIRL thickness in advanced glaucoma was significantly less than normal subjects (P=0.04). The mean mORL thickness in early and advanced glaucoma was not statistically significant different from that of normal subjects (P>0.8). There was no statistically significant difference in macular structure-function relationship between the two glaucoma groups (P>0.05). Mean mIRL thickness was significantly associated with MD (P=0.04). CONCLUSION: There was no significant difference in macular structure-function relationship between early and advanced glaucoma groups. Combined data from both glaucoma groups indicated that mIRL thickness was associated with visual sensitivity loss.

Antigenic variations of human influenza virus in Shiraz, Iran.

PURPOSE: Influenza virus is a major cause of human respiratory infections and responsible for pandemics and regional outbreaks around the world. This investigation aims to determine the prevalent influenza genotypes during 2005-2007 outbreaks in Shiraz, the capital city of Fars province, southern Iran and compare the results obtained with those of previous study. MATERIALS AND METHOD: Of the 300 pharyngeal swabs collected from influenza patients, 26 were found to be positive by culture and hemagglutination (HA) assays. Typing and subtyping of the isolates carried out by using multiplex RT-PCR and phylogenetic analysis performed on isolated HA genes using neighbour-joining method. RESULT: Out of 26 positive isolates 12 and 14 were H1N1 and H3N2 respectively. The phylogenetic and amino acid sequence analyses of our H1N1 isolates showed 99-100% genetic resemblance to A/NewCaledonia/20/99 (H1N1) vaccine strain. Most of the Iranian H3N2 isolates varied form A/California/7/2004 vaccine strain in 20 amino acids of which positions 189,226 and 227 were located in antigenic sites of HA1 molecule. These substitutions were not observed in any of the H3N2 subtypes from the same region reported previously. CONCLUSION: The H3N2 subtype strains prevalent during the 2005/7 influenza outbreak in southern Iran demonstrated a drastic antigenic variation and differed from A/California/7/2004 vaccine strain. The H1N1 subtypes showed a notable resemblance to A/NewCaledonia/20/99 vaccine strain and therefore were predicted to be capable of conferring sufficient immunity against H1N1 subtypes.

Selective thinning of the perifoveal inner retina as an early sign of hydroxychloroquine retinal toxicity.

PURPOSE: To evaluate macular thickness profiles using spectral-domain optical coherence tomography (SDOCT) and image segmentation in patients with chronic exposure to hydroxychloroquine. METHODS: This study included eight patients with chronic exposure to hydroxychloroquine (group 1) and eight controls (group 2). Group 1 patients had no clinically evident retinal toxicity. All subjects underwent SDOCT imaging of the macula. An image segmentation technique was used to measure thickness of six retinal layers at 200 microm intervals. A mixed-effects model was used for multivariate analysis. RESULTS: By measuring total retinal thickness either at the central macular (2800 microm in diameter), the perifoveal region 1200-microm-width ring surrounding the central macula), or the overall macular area (5200 microm in diameter), there were no significant differences in the thickness between groups 1 and 2. On an image segmentation analysis, selective thinning of the inner plexiform+ganglion cell layers (P=0.021) was observed only in the perifoveal area of the patients in group 1 compared with that of group 2 by using the mixed-effects model analysis. CONCLUSION: Our study results suggest that chronic exposure to hydroxychloroquine is associated with thinning of the perifoveal inner retinal layers, especially in the ganglion cell and inner plexiform layers, even in the absence of functional or structural clinical changes involving the photoreceptor or retinal pigment epithelial cell layers. This may be a contributing factor as the reason most patients who have early detectable signs of drug toxicity present with paracentral or pericentral scotomas.

Quantitative assessment of conjunctival microvascular circulation of the human eye.

Accessibility to the bulbar conjunctival microvasculature provides a means to assess blood supply to the cerebral cortex and thus optimize therapeutic interventions designed to prevent or reduce the risk of cerebral vascular disease and stroke. The feasibility of a method for quantitative measurements of conjunctiva blood vessel diameter, blood velocity, and flow in the human eye is reported. The method is based on slit lamp biomicroscope digital imaging coupled with a space time image analysis technique. A sequence of conjunctiva microvasculature images was captured at a rate of 50 Hz. The images were analyzed to determine blood vessel diameter, velocity and flow. Blood vessel diameter measurements ranged between 8.7 and 24.3 microns, with a mean value of 15.5 microns. Blood flow rate ranged between 27.3 and 296.9 pl/s, with a mean value of 111.8 pl/s. The relationship between blood flow and vessel diameter was fit with a power law curve (R=0.87). The application of this technique for in vivo quantitative assessment of blood flow dynamics has potential to impact diagnosis and monitoring of various cardiovascular and blood disorders.

Molecular analysis of human influenza virus in Tehran, Iran.

BACKGROUND: To date there are no reports of molecular and phylogenetic analyses of human influenza virus in Tehran, Iran. OBJECTIVES: We isolated and characterized circulating influenza viruses in a sample of patients in Tehran. METHODS: Nasal and pharyngeal swabs were collected from 57 individuals who were suspected of having influenza between October 2005 and January 2007. These samples were cultured and subsequently genotyped by RT-PCR and sequencing analyses. RESULTS: Twelve of 57 samples (21%) were positive for human influenza virus. Out of the 12 positive samples, 7 were A/H3N2 (58%), 3 were A/H1N1 (25%) and 2 were B subtypes (17%). The phylogenetic analysis of the hemagglutinin gene showed that the H1N1 isolates were close to the A/New Caledonia/20/99 and the H3N2 isolates were close to the A/Panama/2007/99 and A/Moscow/10/99 vaccine strains. CONCLUSION: In a sample of clinical patients in Tehran, Iran, the predominant subtype of human influenza virus was determined to be A/H3N2, followed by A/H1N1 and B. In addition, phylogenetic analysis on H1 showed some genetic drifts from vaccine strains, but the phylogeny of H3 demonstrated that these isolates were from the previous vaccine strains.

Chorioretinal vascular oxygen tension in spontaneously breathing anesthetized rats.

PURPOSE: To establish baseline and variability of oxygen tension (PO(2)) measurements in the choroid, retinal arteries, capillaries, and veins of spontaneously breathing anesthetized rats and determine the effect of a moderate surgical procedure on the chorioretinal PO(2). METHODS: Our previously established optical section phosphorescence imaging technique was utilized to measure PO(2) in the chorioretinal vasculatures. Imaging was performed in 29 spontaneously breathing rats under ketamine/xylazine anesthesia. In 7 rats, blood was drawn using a surgically implanted femoral arterial catheter and analyzed to determine the systemic arterial PO(2). The PO(2) measurements in 22 rats without surgery (group 1) and 7 surgically instrumented rats (group 2) were statistically compared. The intrasubject variability was calculated by the average standard deviation (SD) of repeated measurements. RESULTS: The average systemic arterial PO(2) was 52 +/- 7 mm Hg (mean +/- SD) in group 2. In group 1, the average PO(2) measurements in the choroid, retinal arteries, capillaries, and veins were 50 +/- 11, 40 +/- 5, 39 +/- 6, and 30 +/- 5 mm Hg, respectively. No statistically significant PO(2) differences in any of the chorioretinal vasculatures were found between the two groups (p > 0.4). The intrasubject variability was 3 mm Hg in the choroid, retinal arteries, capillaries, and veins. CONCLUSIONS: Chorioretinal PO(2) measurements in spontaneously breathing anesthetized rats have a relatively low variability, indicating that PO(2) changes due to various physiological alterations can be reliably assessed.

Evaluating the effect of reducing the high-dose volume on the toxicity of radiotherapy in the treatment of bladder cancer.

AIMS: The radiation dose used to treat bladder cancer is limited by the risk of inducing severe late bladder toxicity. Retrospective data suggest that radiation tolerance is greater for partial rather than whole bladder irradiation. Limiting the high-dose region to a section of the bladder may reduce toxicity, opening the way for dose escalation. The aims of this study were to establish the efficacy and compare the late toxicity between (1) a two-phase technique limiting the high-dose area and (2) a conventional single-phase radiotherapy to the whole bladder. MATERIALS AND METHODS: A cohort study was undertaken of 229 patients with invasive bladder cancer treated with computed tomography-planned radical radiotherapy at the Royal Marsden Hospital from 1984 to 1998. In total, 154 patients received a single-phase treatment to the whole bladder with a 2 cm margin. Seventy-five patients with solitary, well-localised tumours were selected for treatment using a two-phase technique. The first phase (12 Gy) aimed to treat the tumour with a 2 cm margin. A second phase treated the whole bladder with 52 Gy. One hundred and forty-one patients were planned to receive a dose of 60-64 Gy/30-32 fractions over 6-6.5 weeks, whereas 88 patients received an accelerated regime. Data on late bladder and bowel toxicity (using Radiation Therapy Oncology Group criteria) were collected prospectively at the annual review. RESULTS: At the 5-year follow-up there was no difference in overall survival (hazard ratio = 0.91, 95% confidence interval 0.64-1.3) or failure-free survival (hazard ratio = 1.02, 95% confidence interval 0.73-1.43) between the two techniques. The two-phase reduced volume treatment was less toxic, with a 19% absolute reduction in overall grade 3-4 late toxicity (P = 0.02). These differences were more marked for bladder toxicity compared with bowel toxicity. CONCLUSIONS: The two-phase reduced volume technique was associated with less bladder and bowel toxicity than conventional whole bladder radiotherapy without evidence of impaired survival.

Macular thickness mapping in exudative age-related macular degeneration.

PURPOSE: To report the feasibility of retinal thickness mapping for evaluating thickness differences in retinal areas with and without leakage shown by fluorescein angiography for patients who have age-related macular degeneration with choroidal neovascularization. METHODS: A custom-built version of the retinal thickness analyzer was used for thickness mapping. Retinal thickness was defined as the separation between vitreoretinal and pigment epithelium-choroid interfaces. Imaging was performed in 1 eye of 10 patients with the clinical diagnoses of age-related macular degeneration and choroidal neovascularization. Patients either had never undergone photodynamic therapy at the time of measurement (untreated) or had received one or more photodynamic therapy treatments (treated). Average retinal thicknesses in selected areas with and without the presence of leakage shown by fluorescein angiography were calculated and compared statistically. RESULTS: Retinal thickness (mean +/- SD) in areas with leakage (315 +/- 54 microm) was significantly greater than that in areas without leakage (280 +/- 28 microm) (P = 0.03). In untreated patients, areas with leakage (345 +/- 45 microm) were significantly thicker than areas without leakage (289 +/- 23 microm) (P = 0.02). In treated patients, retinal thickness in areas with leakage (271 +/- 33 microm) and without leakage (267 +/- 34 microm) was similar. CONCLUSION: Retinal thickness mapping may prove to be useful as an adjunct to fluorescein angiography to monitor choroidal neovascularization and its treatment.

Delay in starting treatment for tuberculosis in east London.

In the United Kingdom there is little information about the delay between the onset of symptoms in patients with tuberculosis and the time it takes for them to be correctly diagnosed and treatment started. We have examined the duration and possible causes of such delay in our own district. The records of 93 patients were examined. Total delay in starting treatment was estimated as the time from the start of symptoms to commencement of chemotherapy. Patient delays were estimated from the time between the start of symptoms to the time taken to first attend their general practitioner (GP) with symptoms. Healthcare system delays were estimated from the interval between first being assessed by their GP and starting anti-tuberculosis treatment. Median total delay was 18 weeks (0-219). The time when patients first presented to their GP was determined for 64 patients: median patient delay was then estimated as nine weeks (range 0-104 weeks), and median healthcare delay five weeks, with a very wide range (0.5-210). Prolonged delay was seen in three patients with cervical lymph node disease. Patient delay was significantly longer than healthcare system delay (p = 0.019). Pulmonary disease was associated with shorter total delay in starting treatment compared with extra-pulmonary disease (p = 0.035). In patients with tuberculosis there were considerable delays in first presentation to medical services, in diagnosis and in starting treatment. Patient delays were longer than healthcare system delays. There is a need to improve awareness of the symptoms of tuberculosis both on the part of the general population and of health professionals, especially in areas of high incidence.

Cardiovascular disease as a long-term complication of treatment for testicular cancer.

PURPOSE: To assess the risk of cardiovascular morbidity and cardiac risk factors in long-term survivors of testicular cancer according to treatment received. PATIENTS AND METHODS: All resident male patients registered in the United Kingdom between 1982 and 1992 attending for follow-up were eligible for recruitment. Patients completed a current health questionnaire and underwent clinical review, along with hematologic, biochemical, and hormonal profiles. For patients not under routine review, follow-up information was sought from their general practitioner and mortality data were sought from the Office of National Statistics. Descriptive analysis was performed on all variables and comparisons were made among patients treated by orchidectomy and follow-up only, chemotherapy alone (C), radiotherapy alone (RT), and radiotherapy and chemotherapy (C/RT). RESULTS: Data on cardiovascular events were available on 992 patients. After a median follow-up of 10.2 years, 68 events had been reported, including 18 deaths. After adjusting for age, increased risk for cardiac events was seen after C (relative risk [RR] = 2.59; 95% confidence interval [CI], 1.15 to 5.84; P =.022), RT (RR = 2.40; 95% CI, 1.04 to 5.45; P =.036), and C/RT (RR = 2.78; 95% CI, 1.09 to 7.07; P =.032). There were no significant differences in cardiac risk factors. On multivariate analysis, age, treatment group, free thyroxine, protein, and magnesium levels were associated with cardiovascular disease. CONCLUSION: In long-term survivors of testicular cancer, we observed a two-fold or greater risk of developing cardiovascular disease. This was not due to increases in cardiac risk factors, which suggests a direct or indirect treatment effect. These data support the continued research into the minimization of treatment in good-prognosis testicular cancer.

Heterotopic bone formation: irradiation of high risk patients.

The Royal Marsden Hospital has adopted a policy for patient selection for the use of adjuvant radiotherapy to prevent heterotopic new bone formation (HTBF) limited to those at greater than 50% risk. The treatment protocol is 7 Gy post-operative megavoltage radiotherapy at mid-plane, in one fraction, given within 72 h of surgery. Since the introduction of this protocol in 1993, 26 joints have been treated in 25 patients. The majority of cases were young people with acetabular fractures resulting from road traffic accidents, often alcohol related. Follow-up studies in this group of patients has proved difficult, as many fail to attend for follow up, and others have moved out of the catchment area. Of the 14 cases for which follow-up data is available, 13 remain fully mobile. One has not mobilized since the time of treatment and continues to use crutches. There is one case of recurrent HTBF seen on X-ray after 8 months, but the joint was mobile. By 5 years, all cases have failed to attend for follow-up. The true long-term risks of this treatment policy may not be known for 30 years. The failure of patients to attend even short-term follow-up is a potential problem for clinical oncologists.

Retinal topography and thickness mapping in atrophic age related macular degeneration.

AIM: To determine the relation between alterations in the retinal topography and thickness, visual acuity, and retinal pigment epithelium hypopigmentation in atrophic age related macular degeneration (AMD). METHODS: 22 patients, mean age 74 (SD 8) years, with atrophic AMD were recruited. An optical imaging system based on the retinal thickness analyser (RTA) was applied to generate a series of 20 optical section images that encompass 2 mm x 2 mm retinal areas. The optical section images were digitised and analysed to provide topographic maps of the vitreoretinal and chorioretinal surfaces and the retinal thickness. Vitreoretinal and chorioretinal surface elevations and retinal thickness were determined. RESULTS: Variation in the vitreoretinal surface height was moderately correlated with visual acuity (r = -0.4; p = 0.03; n = 22). Increase in variation of chorioretinal surface height was correlated with decrease in visual acuity (r = -0.5; p = 0.01; n = 22). The retinal thickness was not associated with visual acuity (r = 0.2; p = 0.2; n=22). Relative height of the vitreoretinal surface in eyes with retinal pigment epithelium (RPE) hypopigmentation was significantly less than eyes without RPE hypopigmentation (p = 0.005). Eyes with and without RPE hypopigmentation had a similar relative height of the chorioretinal surface (p = 0.4). Retinal thickness in eyes with RPE hypopigmentation was less than in eyes without RPE hypopigmentation (p = 0.04). CONCLUSION: Mapping of chorioretinal and vitreoretinal topography and retinal thickness provides objective and quantitative measurements of retinal structural abnormalities and shows promise as an adjunct for the evaluation of retinal structural changes due to AMD.

Recovery of serum testosterone, LH and FSH levels following neoadjuvant hormone cytoreduction and radical radiotherapy in localized prostate cancer.

This study was carried out to evaluate the possible long-term endocrine effect of short-term neoadjuvant leuteinizing hormone-releasing hormone analogue (LHRHa) administration in localized prostate cancer. A total of 419 men were treated for 3-6 months at The Royal Marsden NHS Trust by neoadjuvant androgen suppression using monthly depot injections of LHRHa before radical radiotherapy. Serum testosterone (852 measurements), leuteinizing hormone (LH) (799 measurements), and follicle-stimulating hormone (FSH) levels (801 measurements) were grouped according to their timing in relation to hormonal treatment and then analysed. Suppression of pituitary gonadotrophins and testosterone after the administration of LHRHa and their recovery after cessation of the drug was clearly observed. Median serum testosterone levels decreased from 16 nmol/l to 14 nmol/l when comparing prehormonal and follow-up phases. The same comparison showed an increase in median serum LH and FSH levels, with the median LH rising from 5 u/l to 8 u/l and the median serum FSH rising from 6 u/l to 20 u/l. On long-term follow-up, three of 256 men have remained with testosterone levels in the castrate range. Similar highly significant results were seen in subgroup of 103 men who had both pre-LHRHa and follow-up hormone levels analysed (P=0.012, P<0.001, P<0.001 for testosterone, LH and FSH respectively). Our data suggest the possibility of residual gonadal dysfunction after short-term LHRHa administration and radical radiotherapy in localized prostate cancer. Serum testosterone levels are restored to normal levels in the majority of patients, with a compensatory increase in serum levels of LH.

Findings on retinal topography and thickness mapping in age-related macular degeneration.

PURPOSE: To report alterations in the retinal topography and thickness in typical cases of age-related macular degeneration (ARMD). METHODS: An optical imaging system was applied to patients with ARMD with alterations in the retinal structures. The system generates a series of 20 optical section images that encompass a 2 mm x 2 mm retinal area. The optical sections are digitized and analyzed to provide topographic maps of the vitreo-retinal and chorio-retinal surfaces and the retinal thickness. RESULTS: Retinal topography and thickness mapping in a normal eye corresponded to normal anatomy. Topographic mapping in a patient with confluent drusen indicated elevation of the vitreo-retinal surface. Retinal topography in a patient with retinal pigment epithelium detachment displayed localized elevation of the chorio-retinal surface. The thickness map in a patient with geographic atrophy of the retinal pigment epithelium revealed retinal thinning. In the patients with choroidal neovascularization, the vitreoretinal and chorio-retinal surfaces were elevated. The chorio-retinal surface map in a patient with evolving disciform scar displayed topographic variations corresponding to the fibrovascular tissue underlying the serous detachment. CONCLUSION: Retinal topography and thickness mapping is useful for visualization and evaluation of pathologic alterations in retinal structures due to ARMD.