Effectiveness of latanoprost (Xalatan) monotherapy in newly discovered and previously medicamentously treated primary open angle glaucoma patients

We evaluated the effectiveness of latanoprost (Xalatan) monotherapy in primary open angle glaucoma (POAG). Latanoprost is a prostaglandin analogue, the pure 15(R) epimer of 13,14-dihydro-17-phenyl-18,19,20-trinor-PGF2alpha-isopropyl ester. As a prodrug it is being activated by enzymatic hydrolysis in the cornea after which it becomes active acid of latanoprost. Latanoprost is lowering the intraocular pressure (IOP) by increasing the uveoscleral outflow. In this study, latanoprost was used once daily as monotherapy what offers much better compliance for the patients than other combinations of drugs, preserving good IOP control. Based on the significant reduction of the IOP, measured on the day 60 of the trial (mean change in IOP was -5.1 mmHg, with 95% confidence interval in range from -5.6 to -4.5), it is concluded that use of latanoprost is advisable when calculating better IOP control, few side-effects and reductions in costs of potential surgical procedures.     

Influence of psychosocial work-related factors on conventional risk factors of ischemic heart disease and homocysteine in Slovenian male workers

The influence of psychosocial work-related factors on the conventional risk factors of ischemic heart disease (IHD), particularly on the lipid changes and their effect on homocysteine is studied in this paper. Employed males aged 35 to 55 with angina pectoris or a myocardial infarction (IHD group) were compared to a group of individuals without ischemic heart disease (Control Group). Psychosocial factors were assessed using a Swedish Theorell questionnaire. The IHD Group was found to be at a higher risk of IHD due to higher work demands (OR = 1.25), worse job control (OR = 1.23), frequent smoking (OR = 2.2), leadership positions (OR = 3.97), higher BMI (p = 0.059) and higher levels of triglycerides (p = 0.005) and LDL-cholesterol (OR = 1.65). The level of HDL-cholesterol was significantly lower (1.0 vs. 1.4 mmol/L, p < 0.001, OR = 1.64), while the level of C-reactive protein (9.1 vs. 1.8 mg/L) and Interleukin-6 (6.5 vs. 1.6 ng/L) was higher. Homocysteine levels showed borderline significance (p = 0.056). Our study suggests a possible influence of psychosocial work-related factors on IHD risk factors, most of all on low HDL-cholesterol. No connection was found between psychosocial factors and the homocysteine level, shown to be an IHD risk factor at lower levels of approximately 10 micromol/L.     

Radiofrequency ablation as locoregional therapy for unresectable hepatic malignancies: initial results in 24 patients with 5-years follow-up

Radiofrequency ablation (RFA) is one treatment modality for unresectable liver metastases. Patients with hepatic malignancies (n = 24) underwent elective RFA. All tumors were ablated with a curative intent, with a margin of 1 cm, in a single session of RFA. The median diameter of tumor was 3.1 cm (range 1.7-6.9 cm). Studied patients were not candidates for resection due to multifocal hepatic disease, extrahepatic disease, proximity to major vascular structures or presence of cirrhosis with functional hepatic reserve inadequate to tolerate major hepatic resection. Complete tumor necrosis was achieved in 87.5% and tumor recurred in 3 patients (12.5%) with lesions larger than 5 cm. Distant intrahepatic recurrence was diagnosed in another 4 (16.7%). Distant metastases were found in 7 (29.2%) patients. Four of these 7 patients had also distant intrahepatic recurrence of disease. Two and 5-years survival rates were 41.7% (10 patients) and 8.3% (2 patients) respectively. RFA is safe and effective option for patients with unresectable hepatic malignancies smaller than 5 cm without distant metastatic disease. RF ablation resulted in complete tumor necrosis in 87.5% with 2 and 5-years survival rates much higher than with chemotherapy alone or only supportive therapy, when survival is measured in weeks or months. If RFA is unavailable, percutaneous ethanol injection therapy can be done but with inferior survival rates.     

Gap regeneration and replacement patterns in an old-growth <Emphasis Type="Italic">Fagus</Emphasis>–<Emphasis Type="Italic">Abies</Emphasis> forest of Bosnia–Herzegovina

We examined the influence of small-scale gap disturbances on stand development and tree species coexistence in an old-growth Fagus sylvatica–Abies alba forest in the Dinaric Mountains of Bosnia–Herzegovina. The structure and composition of tree regeneration in gaps were compared to the forest as a whole, and the influence of gap size on the density and composition of regeneration was assessed. Transition probabilities were also calculated from gapfillers in different life stages to examine canopy replacement patterns. The structure and composition of tree regeneration were similar between gaps and the forest as a whole, and there was no relationship between overall regeneration density and gap size, indicating most individuals established prior to gap formation. Likewise, there was no strong evidence of gap-size partitioning for shade tolerant F. sylvatica and A. alba, although less tolerant Acer pseudoplatanus only recruited to taller life stages in larger gaps. Transition probabilities calculated from the seedling and sapling data suggest that most gaps will be captured by F. sylvatica, while probabilities based on pole-sized gapmakers indicate both A. alba and F. sylvatica will be maintained in the canopy. We suggest that gaps primarily play a role in reorganizing advance regeneration, and that coexistence of shade tolerant F. sylvatica and A. alba is more likely related to their differential ability to tolerate shaded understory conditions, particularly during larger life stages, rather than gap-size partitioning.     

The expression of interleukin-1 alpha, TNF and VEGF in corneal cells of patients with bullous keratopathy

Bullous keratopathy (BK) is a chronic corneal edema with or without subepithelial bullae as a result of a loss of the endothelial cells. 15 patients with BK after cataract surgery with intraocular lens implantation, due to Fuchs dystrophy (n = 3) or corneal endothelial trauma (n = 12) were included in the study. All patients were treated by amniotic membrane transplantation (AMT). Corneal epithelial cells in patients suffering from BK secreted 3.91 +/- 3.09 pg/mL of IL-1 alpha, 4446 +/- 16.8 pg/mL of TNF and 81.43 +/- 37.81 pg/mL of VEGF-I. Levels of all 3 investigated cytokines were significantly higher as compared to controls (p < 0.005). Amniotic membranes that were used to treat investigated patients contained 638.98 +/- 613.98 pg/mL of IL-1ra, 0.026 +/- 0.009 pg/mL of sTNF and 81.39 +/- 21.01 pg/mL of VEGF-R. Beneficial clinical effect of the AMT in treating BK could be explained by its natural production of pro-inflammatory cytokine antagonists such as IL-ra, sTNF antagonist and VEGF-R.     

Transplantation of amniotic membrane in corneal ulcers and persistant epithelial defects

Amniotic membrane transplantation (AMT) leads to reduction of inflammatory symptoms and causes faster epithelisation in corneal ulcers and persistant epithelial defect. 21 patients with corneal ulcer (n = 18) or non-healing epithelial defect (n = 3) unresponsive to conventional treatment were included in the study. All patients were treated by AMT. Corneal epithelial cells in patients suffering from corneal ulcer secreted 3.51 +/- 1.79 of IL-1alpha, 64.27 +/- 31.53 pg/mL of TNFalpha and 209.07 +/- 201.82 pg/mL of VEGF. Levels of all 3 investigated cytokines were significantly higher as compared to controls (p < 0.005). Amniotic membranes that were used contained 775.69 +/- 613.98 pg/mL of IL-1alpha, 0.036 +/- 0.033 pg/mL of sTNF and 175.01 +/- 166.63 pg/mL of VEGF-R. Supporting effect of the AMT could be explained by the fact that AM secretes its natural antinflammatory antagonists IL-1ra, sTNF and VEGF-R.     

Effect of scuba diving on the oxidant/antioxidant status,SIRT1 and SIRT3 expression in recreational divers after a winter nondive period

The aim of this study was to examine the effects of scuba diving on oxidative damage markers in erythrocytes and plasma, antioxidant system in peripheral blood mononuclear cells (PBMCs), as well as sirtuin 1 (SIRT1) and sirtuin 3 (SIRT3) gene expressions in recreational divers after a winter nondive period (at least 5 months). For that purpose, 17 male recreational divers performed an immersion at a depth of 30 m for 30?min. Blood samples were collected immediately before and after diving, 3 and 6?h after diving. Erythrocyte lipid peroxidation measured by thiobarbituric-reactive substances (TBARS) method was significantly increased immediately after diving, but returned to the baseline 6?h after diving, while no significant change was found for plasma TBARS and protein carbonyl derivates in both plasma and erythrocytes. Diving-induced catalase (CAT), superoxide dismutase 2 (SOD2), and consequently total superoxide dismutase (SOD) activities in the PBMC samples (significantly increased immediately after diving, reached the maximum activities 3?h after diving, while 6?h after diving only CAT activity remained significantly increased). No significant change was observed for SOD1 activity and gene expression, as well as SOD2 expression, while CAT and SIRT1 expressions were slightly decreased immediately after diving and 3?h after diving. Interestingly, SIRT3 expression was significantly increased 6?h after diving. In conclusion, after the first dive to 30 m after a nondive season, activation of antioxidant defence was not sufficient to prevent oxidative damage, while SIRT3 upregulation could be a step towards an adaptive response to the diving.     

Changes in extracellular acid-base homeostasis in cerebral ischemia

The purpose of this study was to examine the changes in extracellular CO ₃ ²⁻ and lactate concentration produced by ischemia, especially in relation to the occurrence of anoxic depolarization, and how some of these changes are altered by the inhibition of organic acid transport systems with probenecid. These data demonstrate that (i) the transmembrane mechanisms contributing to intracellular acid-base regulation (Na⁺/H⁺ and HCO ₃ ⁻ /Cl⁻ exchanges, and lactate/H⁺ cotransport) are markedly activated during ischemia; (ii) the efficacy of these mechanisms is abolished as the cellular membrane permeability to ions, including H⁺ and pH-changing anions, suddenly increases with anoxic depolarization; and (iii) efflux of intracellular lactate during ischemia, and its reuptake with reperfusion, mainly occur via a transporter. These findings imply that residual cellular acid-base homeostasis persists as long as cell depolarization does not occur, and strengthen the concept that anoxic depolarization is a critical event for cell survival during ischemia. Special issue dedicated to Dr. Herman Bachelard.