Dos and don'ts to optimize transnasal aerosol drug delivery in clinical practice.

Introduction: Transnasal aerosol drug delivery has become widely accepted for treating acutely ill infants, children, and adults. More recently aerosol administration to wider populations receiving high and low-flow nasal oxygen has become common practice.

Areas Covered: Skepticism of insufficient aerosol delivery to the lungs has been tempered by multiple in vitro explorations of variables to optimize delivery efficiency.

Participants with restricted dominant shoulder internal rotation range of motion demonstrate no side-to-side difference in humeral head translation; and no difference before and after joint mobilization: a pilot study.

[Purpose] To compare humeral head translation (HHT) during shoulder elevation between dominant and non-dominant shoulders in participants with limited dominant shoulder internal rotation range of motion (ROM). To determine if joint mobilization alters HHT, and if relationships exist between the bicipital forearm angle and HHT. [Participants and Methods] Fifteen (9 female) participants (age 25.

Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis.

Palliative care initiatives are needed in nephrology, yet implementation is lacking. We created a 6-hour workshop to teach the skills of active listening, responding to emotion, and exploring goals and values to nurses and social workers working in dialysis units. The workshop consisted of interactive didactics and structured role play with trained simulated patients.

TeXP: Deconvolving the effects of pervasive and autonomous transcription of transposable elements.

The Long interspersed nuclear element 1 (LINE-1) is a primary source of genetic variation in humans and other mammals. Despite its importance, LINE-1 activity remains difficult to study because of its highly repetitive nature. Here, we developed and validated a method called TeXP to gauge LINE-1 activity accurately.

Bilateral recurrent calcareous degeneration of the cornea.

Purpose: To report clinical, histologic, and electron microscopic findings in several consecutive keratoplasties with recurrent pancorneal calcification in a patient with chronic graft versus host disease and severe keratoconjunctivitis sicca following bone marrow transplantation for chronic myelogenous leukemia.

Methods: Altogether 5 penetrating keratoplasties were performed in both eyes for descemetocele formation and corneal perforation as well as pancorneal calcification associated with severe visual loss. Histologic examination and electron microscopy were performed on the corneal buttons obtained.

Histopathological abnormalities in ocular blood vessels of CADASIL patients.

Purpose: To assess histopathological findings in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

Design: Case reports and histopathological evaluation of enucleated eyes.

Methods: Four eyes from two CADASIL patients were enucleated at autopsy and prepared for histopathological analysis using light and electron microscopy.

Retinal vascular abnormalities in CADASIL.

To assess retinal vascular alterations in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, the authors examined 10 affected individuals with ophthalmologic evaluation including fluorescence angiography. Findings included bilateral peripapillary arteriolar sheathing (30%), arteriolar narrowing (80%), and arteriovenous nicking (90%). No retinal infarcts, vascular occlusions, exudation, or hypoperfusion of affected vessels were found.

[Pyogenic granuloma of the lacrimal sac].

Background: Pyogenic granulomata belong to the group of inflammatory pseudotumours. They consist of granulation tissue usually following inflammatory processes or trauma.

Patient: We report on a 86-year old female suffering from chronic dacryocystitis.

[New automated microkeratome for trepanation of lamellar keratoplasty].

Background/purpose: Lamellar keratoplasty is an established therapy of corneal pathologies without endothelial involvement and the lack of endothelial rejection is one of the major advantages compared to penetrating keratoplasty. The major disadvantages of manually prepared lamellar corneal grafts are the limited mechanical and optical quality but the automated lamellar therapeutic keratoplasty system ALTK (MORIA) is intended to overcome these disadvantages. The purpose of this preliminary work is to investigate histologically and in clinical cases, if the ALTK system can achieve this aim.

[Nocardia farcinica: life-threatening chorioiditis under systemic immunosuppression].

Background: Immunosuppressed patients occasionally suffer from a multifocal infection with Nocardia. It is important to distinguish Nocardia farcinica from Nocardia asteroides, because of different sensitivity against antibiotics.

Patient And Methods: A 40-year-old patient with polycystic renal disease successfully underwent a kidney transplantation without complications.

Vitreoretinal morphology of plasmin-treated human eyes.

Purpose: To investigate the ultrastructure of the vitreoretinal interface following an intravitreal injection of plasmin.

Methods: Plasmin (2 U/0.1 ml) was injected into the vitreous cavity of five postmortem human eyes.

Preoperative evaluation of limbal dermoids using high-resolution biomicroscopy.

Background: Only a few case reports have described the ultrasound biomicroscopic features of limbal dermoids. It remains unclear whether examination by ultrasound biomicroscopy (UBM) can detect the corneal depth of penetration which would improve planning of surgery.

Methods: Eight consecutive patients [two female, six male, 1-24 years old (median 8.

[3-D ultrasound. Initial experiences in various eye diseases].

Background: Studies have confirmed three-dimensional (3-D) ultrasound as a practical diagnostic tool in examining the eye and orbit and suggest its routine clinical use.

Materials And Methods: 3-D ultrasound was prospectively performed in 46 patients (46 eyes) with various ocular diseases. In six large choroidal melanomas the tumor volume were measured by 3-D ultrasound and compared to that measured by MRI and to that calculated by a theoretical formula.

[Bilateral retinal microangiopathy in interferon therapy of malignant melanoma of the skin].

Background: Interferon associated retinopathy has been described mainly by Japanese working groups as a complication of systemic interferon therapy for various diseases. In Europe, only few reports exist, especially regarding interferon therapy for dermal malignant melanoma.

Patient: We report a 58-year-old female patient with symptomatic, bilateral microangiopathy caused by interferon for metastatic dermal malignant melanoma.

[Stereotaxic precision irradiation of large uveal melanomas with the gamma knife].

Background: We report our experience with stereotactic radiosurgery using the Gamma-knife in large uveal melanoma unsuitable for brachytherapy (Ru106).

Patients And Methods: We treated 35 patients (16 male, 19 female; age: median 59 years (95% Confidence interval (CI): 31-84 years; 18 right eyes, 17 left eyes). 7 tumors were located juxtapapillary, 16 tumors were located in the mid-periphery and 12 tumors were located in the ciliary body, The localization and/or the dimension of the tumors did not allow for radiation brachytherapy (Ru106).

In vivo imaging of the human zonular apparatus with high-resolution ultrasound biomicroscopy.

Background: To investigate the potential of high-resolution ultrasound biomicroscopy (UBM) for studying the zonular apparatus of human beings in vivo.

Methods: Using transducer frequencies of 34 MHz and 50 MHz, criteria were developed to identify transcorneal and transscleral sections that allowed reproducible identification of the different fiber groups of the zonular architecture. For that purpose, 10 volunteers between the ages of 14 and 41 years underwent high-resolution ultrasound biomicroscopy under conditions of consensual far- and near-accommodation.

[Choroid neovascularization in age-related macular degeneration. Correlation of histological and fluorescence angiography findings].

Background: Recent studies have raised confusion about the fluorescein angiographical and histopathological correlation of CNV.

Material And Methods: The preoperative fluorescein angiograms of four patients with subfoveal CNV due to ARMD extracted by pars plana vitrectomy were classified as wellor ill-defined CNV and were correlated to the histopathologically (in serial sections) verrified CNV-location (subneuroretinal (= type II according to Gass) versus sub-RPE (type I according to Gass)).

Results: The locations of all four CNV could be classified by histopathological landmarks as there were RPE, BLD/drusen, and inner Bruchs membrane.

[North Carolina macular dystrophy. Hereditary macular disease with good functional prognosis].

Background: North Carolina macular dystrophy (NCMD) is a rare autosomal dominant maculopathy with highly variable expressivity. Genetic analysis of an American family consisting of 247 members out of which 96 were affected with NCMD allowed chromosomal assignment of the NCMD locus to 6q14-q16.2.

[Dural carotid-cavernous sinus fistulas: clinical aspects, diagnosis and therapeutic intervention].

Background: Carotid cavernous fistulas are cerebral artenovenous shunts which may present with ocular or orbital signs. Direct fistulas are distinguished from dural shunts with respect to the anatomical situation.

Patients: We report on two patients with spontaneous dural carotid cavernous fistulas with multiple feeding vessels.

The correlation of cold agglutinin titrations in saline and albumin with haemolytic anaemia.

Cold agglutinin syndrome (CAS) is usually associated with IgM cold agglutinins with titres exceeding 1000 at 4 degrees C and a thermal amplitude of 30-32 degrees C. Occasionally patients are encountered who although having clinical and laboratory findings compatible with CAS do not have the characteristic serological findings. Thirty-two patients with a positive direct antiglobulin test due to complement sensitization were studied.