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PurposeTo analyze the morphology and density of corneal epithelial cells, keratocytes, and subbasal nerves, in patients with early stage Fuchs' endothelial corneal dystrophy (FECD) by in vivo confocal microscopy (IVCM).MethodsIVCM (Confoscan 4, Nidek, Inc.) of the central cornea was performed in 30 corneas of 30 patients with early stage FECD and 13 corneas of 13 normal controls. Images were analyzed for morphology and density of the superficial and basal epithelial cells, keratocyte density, endothelial cell density (ECD), as well as subbasal corneal nerve parameters. Central corneal thickness (CCT) was measured in all patients and normals by ultrasound pachymetry.ResultsThe ECD was significantly lower (−45.5%, P<0.001) in FECD patients as compared with controls. Total number of nerves and main nerve trunks were significantly reduced (−46.3%, P<0.001; −39.7%, P<0.001) in patients with FECD. Posterior keratocyte density was significantly higher in FECD patients (P<0.001). Significant inverse correlations were found between CCT and total number of nerves (r=−0.69, P<0.001), CCT and main nerve trunks (−0.47, P=0.016), as well as CCT and total nerve length (r=−0.62, P=0.006). Significant correlation was found between ECD and total number of nerves (r=0.44, P=0.012) as well as between ECD and main nerve trunks (r=0.65, P<0.001).ConclusionsIVCM demonstrates alterations in corneal innervation in patients with early stage FECD, suggesting a potential role of corneal nerves in the pathogenesis of FECD. Additional studies are required to investigate whether subbasal nerve alterations are caused by nonspecific corneal edema, from FECD-induced decrease in ECD, or potentially leading to loss of endothelial cells. [ABSTRACT FROM AUTHOR]

Within the context of this study, two lab-scale aquatic plant reactors consisting of duckweed (Lemna minor) ponds, were investigated for the removal of nitrogen forms during the secondary treatment of domestic wastewater. TKN, NH3-N and NO3-N parameters have been measured in both reactors for hydraulic retention times ranging from 3.3 days to 23 days and at various distances from the inlet of reactors. The results were evaluated for hydraulic retention times, hydraulic loading rates and mass loading rates. It was concluded that hydraulic and mass loading parameters were more meaningful than hydraulic retention time. Optimum nitrogen removal values of hydraulic loading rate and mass loading rate were found to be 1.2 cm/day and 90-160 mg TKN/m²-day, respectively. At the higher and lower loading rates, nitrogen removal efficiency was lower than those at optimum conditions. Effluent TKN concentration was around 2.5 to 3.0 mg/l while NH3-N concentration was almost zero at these loading conditions. On the other hand, effluent NO3-N concentrations changed between 7 mg/l to 11 mg/l. When investigating the longitudinal profile, values were reduced rapidly along the reactors. It was concluded that most of the nitrogen conversion occurred at the beginning of the reactor. [ABSTRACT FROM AUTHOR]

The aim of this prospective study was to determine the diagnostic value of Tc-99m MDP scintimammography (SMG) for the detection of breast cancer in patients with breast masses and to compare the results with Tc-99m MIBI scintimammography. Twenty patients, categorized as suspicious, positive or benign for breast cancer according to the mammographic findings were included in the study. Dual phase Tc-99m MIBI and Tc-99m MDP SMG were performed in the prone lateral position within 5 days of each other. Although early and late Tc-99m MIBI SMG showed equal (90.4%) sensitivity, the specificity of late Tc-99m MIBI (87.5%) was found superior to early (62.5%) imaging. The overall sensitivity and specificity of early Tc-99m MDP SMG were 71.4% and 62.5%, respectively. Although late Tc-99m MDP imaging showed 100% specificity, its sensitivity was only 23.8%. In the patients with palpable masses, both early Tc-99m MDP and Tc-99m MIBI showed equal sensitivity (100%), but the sensitivity of early Tc-99m MIBI (37.5%) was found slightly higher than Tc-99m MDP (25.0%) for nonpalpable breast lesions. The sensitivity of Tc-99m MIBI and Tc-99m MDP SMG in detecting metastatic axillary involvement was 66.6% and 50%, respectively. High sensitivity and specificity together with its low cost, easy availability and the possibility of detecting bone metastases seems to make Tc-99m MDP a contributive agent in the evaluation of breast lesions as an alternative to Tc-99m MIBI. [ABSTRACT FROM AUTHOR]

Seray Aslan Bayhan, Hasan Ali Bayhan, Ersin Muhafiz, Kadir Kırboğa, Canan Gürdal Department of Ophthalmology, Faculty of Medicine, Bozok University, Yozgat, Turkey Purpose: The aim of the study was to analyze the effects of uneventful phacoemulsification surgery on choroidal thickness (CT) using spectral domain optical coherence tomography (SD-OCT). Methods: In this prospective study, 38 eyes of 38 patients having phacoemulsification surgery were included. All patients underwent detailed ophthalmologic examination, including preo­perative axial length (AXL) measurement with optical biometry and intraocular pressure (IOP) measurement preoperatively and 1 month postoperatively. The CT was measured perpendicularly at the fovea and 1.5 mm temporal, 3.0 mm temporal, 1.5 mm nasal, and 3.0 mm nasal using SD-OCT preoperatively and 1 month postoperatively. Changes in the CT after surgery and correlation of this change with age, AXL, preoperative IOP, and IOP change were evaluated. Results: There was a statistically significant increase in the CT at all regions evaluated. This increment was more prominent in the nasal and subfoveal regions. The IOP decreased significantly 1 month after surgery (16.14±4.94 mmHg vs 13.91±4.86 mmHg; P

The study was designed to investigate the effect of trimebutine maleate, a drug used in both hyperkinetic and hypokinetic motility disorders, on gastric emptying in patients with non-ulcer dyspepsia having prolonged gastric emptying rates and to compare the parameters used for the determination of the lag period observed during the emptying of solid foods from the stomach. Gastric emptying was measured by the radionuclide technique. Twenty normal volunteers and 43 patients with non-ulcer dyspepsia participated in the study. Radionuclide imaging was performed by using a solid meal labeled with 99mTc-tin colloid. Of the patients with non-ulcer dyspepsia, 20 had prolonged gastric emptying. They were given three weeks of oral treatment with trimebutine maleate and had their radionuclide gastric emptying study repeated. Treatment with trimebutine maleate resulted in reduction in duration of the lag period and less retention of food at 100 minutes (p < 0.0005). After treatment with trimebutine maleate, no significant difference has been observed in the mean symptom score of patients with prolonged gastric emptying. Among the parameters used for the determination of the lag period, lag period determined by a mathematical equation (TLAG) has been found to be longer than the lag period determined by visual inspection of the images (VLAG) and there was correlation between the two parameters when the lag time was short. [ABSTRACT FROM AUTHOR]

Seray Aslan Bayhan, Hasan Ali Bayhan Ophthalmology Department, Bozok University Faculty of Medicine, Yozgat, TurkeyWe would like to congratulate Kaercher et al1 on their prospective study of Optive Plus (Allergan, Inc., Irvine, CA, USA) in the treatment of patients with dry eye. In this study the authors reported that Optive Plus effectively reduced the signs and symptoms of patients with all types of dry eye and they recommended the use of this artificial tear especially in lipid-deficient dry eye. We think that some important issues need more thorough discussion.View original paper by Kaercher and colleagues.