A double-crossover trial comparing the effects of topical carteolol and placebo on intraocular pressure.

The effect of topical carteolol 2% on the intraocular pressures of 12 patients suspected of having glaucoma was measured in a double-crossover trial of six weeks' duration. Carteolol produced a significant reduction in intraocular pressure (p less than or equal to 0.001), when compared with placebo.

Ultrasound and ovulation.

Diagnostic ultrasound may be used to both investigate unexplained infertility and monitor all types of infertility treatment in women. Presented in this paper are the numbers of cycles scanned and the numbers of scans performed over the period from November 1981 to March 1986. In patients with unexplained infertility there was only a 39% rate of normality observed with ultrasound.

The effect of twice daily nadolol on intraocular pressure.

The 12-hour control of intraocular pressure obtained with 10 and 20 mg of nadolol twice daily was studied in a placebo-controlled trial. In this ten-week study involving 17 patients a significant reduction in intraocular pressure was obtained with both doses. The effect of 20 mg of nadolol twice daily on intraocular pressure, resting pulse rate, and blood pressure was consistently slightly greater than 10 mg twice daily, but the difference was not significant.

A double-masked crossover study comparing the effects of carteolol 1% and 2% on intra-ocular pressure.

No significant difference was found between carteolol 1% and 2%, when their effects on intraocular pressure were compared over a 4 week treatment period. Twenty ocular hypertensive subjects were recruited for this double-masked crossover trial.

Failure of endotoxin to cross the chorioamniotic membranes in vitro.

We have previously reported the detection of endotoxin in the amniotic fluid of patients with gram-negative intra-amniotic infection. Endotoxin or lipopolysaccharide (LPS) is a potent biologic product capable of inducing prostaglandin release from several cell types, and therefore may be involved in the onset of human parturition in the setting of intra-amniotic infection. The experiments outlined in this report were designed to determine whether endotoxin crosses chorioamniotic membranes in vitro.

Do blood and meconium affect the detection of endotoxin in amniotic fluid with the limulus amebocyte gel clot assay?

The limulus amebocyte lysate (LAL), assay is the most sensitive technique for the detection of endotoxin in biological fluids. Because endotoxin is a component of gram-negative bacteria, the assay has been employed in the detection of gram-negative bacterial contamination of biological fluids. The LAL assay is rapid, inexpensive, easy to perform, and requires little laboratory expertise.

Infection and labor: the detection of endotoxin in amniotic fluid.

Intra-amniotic infections are frequently caused by gram-negative organisms. Lipopolysaccharide, or endotoxin, is a component of the cell wall of these bacteria. The Limulus amebocyte lysate assay is the most sensitive test clinically available for the detection of endotoxin in biologic samples.

A comparison of the effects of oral nadolol and topical timolol on intraocular pressure, blood pressure, and heart rate.

We compared the effects of oral nadolol 20 mg once daily and topical timolol 0.25% twice daily on the intraocular pressures of 22 glaucoma suspects, in a 12 week double-masked crossover study. Both nadolol and timolol reduced intraocular pressure (p less than 0.

Eyes or patients? Traps for the unwary in the statistical analysis of ophthalmological studies.

In reports on ophthalmological research the results of measurements on the eye are often expressed as mean and standard deviation based on m patients, n eyes (n greater than m). This approach leads to t tests that are invalid because the measurements on the two eyes of one subject are usually related, not independent. In a simulation study involving intraocular pressure data analysed in this way, the null hypothesis of no difference between groups was rejected at a nominal alpha = 0.

Interleukin 1 (IL 1) as a mediator of crystal arthritis. Stimulation of T cell and synovial fibroblast mitogenesis by urate crystal-induced IL 1.

We reported before that monosodium urate (MSU) crystals were potent stimulators of endogenous pyrogen (EP) production from human and rabbit mononuclear phagocytes, and proposed that this property of MSU crystals may be important in the pathogenesis of gout. EP activity is now attributed to interleukin 1 (IL 1) peptides but IL 1 is not the only pyrogenic monocyte-derived cytokine, since both interferon-alpha (alpha-IFN) and tumor necrosis factor (TNF) are also pyrogenic in rabbits. Using a T cell comitogenic assay based on a murine helper T cell clone that does not respond to IFN or TNF, we now report the release of IL 1 activity from human blood monocytes and synovial fluid mononuclear cells (MNC), following stimulation with MSU crystals.

Separation of metalloporphyrins from metallation reactions by liquid chromatography and electrophoresis.

The analytical separation of the indium and manganese complexes of three synthetic, meso-substituted, water-soluble porphyrins from their respective free bases in metallation reaction mixtures is described. The ligands tetra-3N-methylpyridyl porphyrin, tetra-4N-methylpyridyl porphyrin and tetra-N,N,N-trimethylanilinium porphyrin are complexed with In (III) and Mn (III) and are separated from residual free base by high-performance liquid chromatography (HPLC) in acidic conditions with gradient elution on ODS bonded stationary phase. Electrophoretic separation is achieved on both cellulose polyacetate strips and polyacrylamide tube gels under basic conditions.

Estrogen-induced transcortin increase and progesterone and cortisol interactions: implications from pregnancy studies.

The concentrations of progesterone, cortisol, estradiol, and transcortin binding capacity (TBC) were measured in plasma samples of women during normal pregnancy. Between 10 weeks and 20 weeks gestation, the mean of TBC increased linearly, and the mean increase in TBC for a given estradiol increment was constant until the estradiol concentrations reached approximately 30 nmol per liter. The results were consistent with the increase in TBC having been induced by estradiol; however, there was an inherent upper limit of response.

Impairment of colour vision associated with amiodarone keratopathy.

Objective changes in colour vision have not been demonstrated previously in patients on long-term amiodarone therapy, although the occurrence of blurring of vision and seeing coloured haloes around lights has been widely reported. In a masked study, colour vision was assessed in 15 patients who had been treated with amiodarone for 16-72 months. Subjects with extensive corneal microdeposits (Miller stage 3) had worse colour vision than subjects with mild or moderate corneal changes (Miller stages 1 and 2) (P = 0.

Loop recession of the recti muscles.

Scleral penetration with a suture needle is a well recognised risk of the surgical treatment of strabismus and may result in serious intra-ocular complications. The risk should be reduced by loop recession, a procedure derived from the adjustable suture technique. In practice in many cases this operation has also been found to have other advantages compared to a conventional recession.

The realities of screening for the small for dates fetus using ultrasound measurement.

Screening for the small for dates fetus using ultrasound measurement of the fetal abdominal circumference resulted in a significantly increased rate of diagnosis compared with clinical examination. However, when the perinatal mortality and morbidity amongst infants with a birthweight less than the 10th percentile for gestation in the screened group was compared with that of similar infants in a nonscreened groups who attended the same antenatal clinic but who either booked or were referred late, there was no significant difference.

Interleukin 1 activity produced by human rheumatoid and normal dendritic cells.

Dendritic cells (DC) from the synovial inflammatory tissue and peripheral blood of patients with rheumatoid arthritis and from the peripheral blood of normal blood donors were compared with the autologous monocytes for their capacity to produce and release interleukin 1 (IL-1). Synovial DC often spontaneously released higher amounts of IL-1 activity than unstimulated and lipopolysaccharide-stimulated peripheral blood DC and monocytes. The IL-1 production by both DC and monocytes increased after stimulation with bacterial lipopolysaccharide.

Is fever beneficial to the host: a clinical perspective.

Fever is a phylogenetically ancient host response to infection, being found in fish and lizards, and conserved, with all its metabolic costs, in the higher mammals, including man. The conservation of the fever response in evolution is used as an argument for its survival value and, indeed, in experiments with cold-blooded animals "behavioral fever" has been demonstrated to reduce mortality associated with infection. Recent advances in the biology of interleukin-1 and other cytokines have allowed the testing, in vitro, of components of mammalian host defense (such as immune cell function) at temperatures typical of fever, and marked effects have been found.

Second trimester maternal serum alpha-fetoprotein as an indicator of fetal risk.

Serum alpha-fetoprotein levels were raised to 2.0 or more times the median for gestation in 30 of 507 singleton pregnancies after excluding pregnancies complicated by fetal neural tube defects. The serum alpha-fetoprotein levels were significantly more often elevated in pregnancies complicated by prematurity, fetal heart rate abnormalities, delivery of a small for dates infant, a perinatal death and admission of the baby to the neonatal unit.

Crystal-induced endogenous pyrogen production. A further look at gouty inflammation.

We found previously that crystals of sodium urate and silicon dioxide (silica) can stimulate the production of endogenous pyrogen (EP), now called interleukin-1 (IL-1), the polypeptide mediator of fever and other aspects of inflammation. We have confirmed and extended the work with urate crystals and have examined 2 other crystals associated with joint problems, hydroxyapatite (HA) and calcium pyrophosphate dihydrate (CPPD). The crystals were added to suspensions of human blood leukocytes (2.

Experimental freeze-preservation of chondrocytes.

Preservation of articular cartilage chondrocytes is currently being investigated in conjunction with storage and transplantation of osteochondral allografts. Studies on isolated chondrocytes have suggested that viability and function may be retained following freeze-preservation. Up to 90% of frozen isolated cells will survive, and these cells are capable of producing proteoglycans in culture.

Caesarean section in Christchurch.

Base hospital caesarean section rates in Christchurch have risen from 4.1% in 1967 to 14.1% in 1982.

Prenatal diagnosis of Candida albicans chorioamnionitis.

The use of diagnostic amniocentesis has been proposed for the evaluation of patients with clinical suspicion of chorioamnionitis, such as those with premature rupture of membranes and premature labor. We describe a patient in whom the diagnosis of Candida chorioamnionitis was made after diagnostic amniocentesis with the assistance of a simple and rapidly performed potassium hydroxide smear.