Pseudoexfoliation and glaucoma in eyes with retinal vein occlusion.

Purpose: To evaluate pseudoexfoliation (PE) and pre-existent glaucoma in eyes with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO).

Methods: Consecutive eyes with a diagnosis of BRVO (73 eyes of 70 patients) and CRVO (53 eyes of 49 patients) examined between July and December 1998 comprised the study eyes. Age-matched control group consisted of 384 eyes of 192 outpatients.

Detection of T-cell receptor-gamma gene rearrangement in lymphoproliferative disorders by temperature gradient gel electrophoresis.

Objective: Polymerase chain reaction amplification of DNA for T-cell receptor (TCR) gene rearrangement analysis is helpful in the evaluation of T-cell lymphoproliferative disorders. Detection of polymerase chain reaction products is limited by the poor resolution of bands analyzed by agarose or polyacrylamide gel electrophoresis. To improve the detection of a clonal T-cell population, we used temperature gradient gel electrophoresis (TGGE) as an alternative method for analysis of TCR gene rearrangement.

Constitutive expression of NF-kappa B is a characteristic feature of mycosis fungoides: implications for apoptosis resistance and pathogenesis.

The NF-kappa B family of transcription factors is an important regulator of genes expressed during inflammatory responses, immunoglobulin (Ig) class switching, cellular differentiation, and apoptosis. Recently, members of the NF-kappaB family, including p65(Rel A), have been implicated in promoting survival of various hematopoeitic neoplasms, including T cell malignancies such as adult T cell leukemia-lymphoma. We investigated the expression of active NF-kappa B p65(Rel A) in cases of mycosis fungoides (MF) and the effect of chemical inhibitors of NF-kappa B on apoptosis in cutaneous T cell lymphoma (CTCL) cell lines.

Expression of the tumor necrosis factor receptor-associated factors (TRAFs) 1 and 2 is a characteristic feature of Hodgkin and Reed-Sternberg cells.

Tumor necrosis factor receptor-associated factors (TRAFs) are a recently established group of proteins involved in the intracellular signal transduction of several members of the tumor necrosis factor receptor (TNFR) superfamily. Recently, specific members of the TRAF family have been implicated in promoting cell survival as well as activation of the transcription factor NF-kappaB. We investigated the constitutive expression of TRAF1 and TRAF2 in Hodgkin and Reed-Sternberg (HRS) cells from archived paraffin-embedded tissues obtained from 21 patients diagnosed with classical Hodgkin's disease (HD).

Results of immediate surgical treatment of all acute type A dissections.

Background: Surgery for acute type A aortic dissection is associated with a high mortality rate and incidence of postoperative complications. This study was designed to explore perioperative risk factors for death in patients with acute type A aortic dissection.

Methods And Results: One hundred twenty-four consecutive patients with acute type A aortic dissection between 1984 and 1998 were reviewed.

Characterization of apoptosis induced by protein kinase C inhibitors and its modulation by the caspase pathway in acute promyelocytic leukaemia.

Acute promyelocytic leukaemia (APL;M3) is a unique form of acute myelogenous leukaemia characterized by t(15;17) translocation. The induction of apoptosis via inhibiting protein kinase C (PKC) has been recently viewed as a promising tool for the eradication of several malignant disorders. In the present study, we investigated the effect of two different protein kinase C inhibitors, Gö6976 and safingol, on the induction of apoptosis in the APL cell line NB4 and its all trans retinoic acid (ATRA)-resistant variant NB4.

Predictors of adverse outcome and transient neurological dysfunction after ascending aorta/hemiarch replacement.

Background: This study was undertaken to determine predictors of adverse outcome and transient neurological dysfunction after replacement of the ascending aorta with an open distal anastomosis.

Methods: All 443 patients (300 male, median age 63) undergoing replacement of the ascending aorta with an open distal anastomosis between 1986 and 1998 were included in the analysis. The ascending aorta alone was replaced in 190 (42.

Surgical techniques. Aortic arch and deep hypothermic circulatory arrest: real-life suspended animation.

Surgical reconstruction of the aortic arch is a complex procedure requiring careful preoperative analysis of the pathology and forethought toward surgical approach. Development of surgical techniques has brought dramatic improvement survival and reduction of neurological events associated with these procedures, yet significant morbidity is still encountered. New approaches to the patient with these pathologies include antegrade and retrograde perfusions to the brain.

Descending thoracic and thoracoabdominal aneurysm.

The low incidence of permanent spinal cord injury in our most recent cohort (Group II) of patients suggests that serial sacrifice of intersegmental vessels, careful monitoring of spinal cord function are effective in preventing paraplegia after descending thoracic and thoracoabdominal aneurysm operations. Updated anesthetic and postoperative care minimized overall mortality risk. (Ref.

Subtypes of acute aortic dissection.

Background: This series consists of a 12-year experience with a policy of identifying and replacing the aortic segment containing the primary intimal tear for repair of acute aortic dissection.

Methods: Patients with type A dissection underwent urgent surgery. Patients with type B dissection were referred for surgery based on selective criteria, including aortic dilatation greater than 5 cm.

Use of somatosensory evoked potentials for thoracic and thoracoabdominal aortic resections.

Background: Despite tremendous development in surgical and anesthetic techniques, resection of the thoracic and thoracoabdominal segments of the aorta remain associated with the risk of paralysis. Routine use of somatosensory-evoked potential (SEP) monitoring in patients undergoing surgery of the thoracic aorta has become a standard intra- and postoperative procedure at our institution since its first use in 1993.

Methods: One hundred forty nine (149) thoracic aortic operations were performed during January 1993 through January 1998 using SEP-directed serial sacrifice of paired intercostal arteries.

Natural history of descending thoracic and thoracoabdominal aneurysms.

Background: A review of 165 patients with chronic dissecting and degenerative aneurysms of the descending thoracic and thoracoabdominal aorta initially managed nonoperatively was carried out to ascertain factors associated with a high risk of rupture.

Methods: Changes in the aneurysms were followed with three-dimensional reconstructions of computed tomograph scans. Risk factors were compared in patients with dissecting and nondissecting aneurysms who experienced rupture, in whom operation was recommended during the course of follow-up, and in those without rupture or operation.

Cerebral metabolic suppression during hypothermic circulatory arrest in humans.

Background: Hypothermic circulatory arrest (HCA) is used in surgery for aortic and congenital cardiac diseases. Although studies of the safety of HCA in animals have been carried out, the degree to which metabolism is suppressed in patients during hypothermia has been difficult to determine because of problems with serial measurements of cerebral blood flow in the clinical setting.

Methods: To quantify the degree of metabolic suppression achieved by hypothermia, we studied 37 adults undergoing operations employing HCA.

Temporary neurological dysfunction after deep hypothermic circulatory arrest: a clinical marker of long-term functional deficit.

Background: With increasing clinical experience, it has become clear that two distinct forms of neurological injury occur after operations on the thoracic aorta that require temporary exclusion of the cerebral circulation. Traditionally, evaluation of neurological outcome was limited to reporting the incidence of postoperative stroke related to ischemic infarcts due to particulate embolization. More recently, the symptom complex defined as "temporary neurological dysfunction" (TND) was recognized as a functional manifestation of subtle and presumably transient brain injury, but whether this early postoperative syndrome is associated with long-term deficits of cognitive and intellectual functions has not been established.

Surgical treatment of the dilated ascending aorta: when and how?

Background: The aorta is considered pathologically dilated if the diameters of the ascending aorta and the aortic root exceed the norms for a given age and body size. A 50% increase over the normal diameter is considered aneurysmal dilatation. Such dilatation of the ascending aorta frequently leads to significant aortic valvular insufficiency, even in the presence of an otherwise normal valve.

Emergence of regulatory CD4+ T cell response to repetitive stimulation with antigen-presenting cells in vitro: implications in designing antigen-presenting cell-based tumor vaccines.

Because APCs play a crucial role in the generation of T cell-mediated immune responses, numerous clinical trials with APC-based vaccines have been initiated in different types of human cancers. Encouraging results have emerged from some of these initial studies. Thus far, APC-based vaccinations usually include multiple rounds of immunization.

Retinal breaks and rhegmatogenous retinal detachment in association with branch retinal vein occlusion.

Background And Objective: To report the incidence and clinical characteristics of retinal breaks and/or rhegmatogenous retinal detachment (RRD) in patients with branch retinal vein occlusion (BRVO).

Patients And Methods: We reviewed the clinical records of 230 eyes of 214 patients with BRVO and identified eyes with retinal breaks and/or RRD. Patients had at least 6 months of follow-up.

Risk factors for rupture of chronic type B dissections.

Objective: This study was an attempt to determine risk factors for rupture and to improve management of patients with type B aortic dissection who survive the acute phase without operation.

Methods: We studied 50 patients by means of serial computer-generated 3-dimensional computed tomographic scans. All patients who did not undergo operative treatment before the completion of at least 2 computed tomographic scans a minimum of 3 months apart after an acute type B dissection were included in the study.

Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery.

Unlabelled: Transfusion therapy after cardiac surgery is empirically guided, partly due to a lack of specific point-of-care hemostasis monitors. In a randomized, blinded, prospective trial, we studied cardiac surgical patients at moderate to high risk of transfusion. Patients were randomly assigned to either a thromboelastography (TEG)-guided transfusion algorithm (n = 53) or routine transfusion therapy (n = 52) for intervention after cardiopulmonary bypass.