Chronic topical administration of WIN-55-212-2 maintains a reduction in IOP in a rat glaucoma model without adverse effects.

Glaucoma, one of the leading causes of blindness, is associated with high intraocular pressure (IOP) as a risk factor. The aim of this study was to examine both local and systemic effects of chronic topical administration of the synthetic CB1/CB2 agonist, WIN-55-212-2 and its potential to sustain ocular hypotension. WIN-55-212-2 (0.

The intriguing problem of varicose veins.

New methods of investigation have given a fresh understanding of varicose veins. Aspects of this are described based on findings in patients investigated by Doppler flowmetry, functional phlebography and photoplethysmography. All observations refer to the upright position where various forms of failure in pumping blood upwards against gravity may arise.

Varicocele and varicose veins compared. A basis for logical surgery.

In the past only large symptomatic varicoceles were treated surgically, but this has changed now that they are believed to be a cause for infertility. Ten patients have been studied using the Doppler flowmeter and phlebography to compare varicoceles and varicose veins in the legs and to decide whether or not the same principles apply in their surgical treatment. These studies have confirmed a similar mechanism of retrograde flow from above a pumping mechanism to below it.

Direction of flow in superficial veins as a guide to venous disorders in lower limbs.

Clinical methods and directional Doppler velocimetry applied to superficial veins have been used to study 527 patients with venous disorders in the lower limbs. Phlebography assisted by the image intensifier has been carried out in 80 of these patients. All examinations have been done with the patient upright, exercising, and without use of any artefact, such as a tourniquet.

Expanded polytetrafluoroethylene grafts for severe lower limb ischaemia.

Three years' experience with the use of expanded polytetrafluoroethylene grafts for severe lower extremity ischaemia are reported; 44 femoropopliteal bypasses were performed, 35 for limb salvage. The prosthesis was used when no saphenous vein was available (23) or to shorten operation time in infirm patients (21). Of 41 patients with a mean age of 70 years, 19 had significant ischaemic heart disease and 10 were diabetic.

Intermittent claudication: factors determining outcome.

Two groups of patients were followed up for four to eight years after first referral or admission to hospital for intermittent claudication (IC) in a study of the natural history of the disease and of factors determining its outcome. In one series of 60 patients, those who stopped or reduced smoking after referral had a much improved prognosis. Thus even after the diagnosis of IC it is extremely important that patients should be encouraged to stop smoking, since this correctable factor appears to be of greater importance in determining outcome than other medical risk factors for the disease that are less amenable to treatment.

Influence of the type of anastomosis: end-to-side anastomosis versus end-to-end.

The by-pass technique of arterial reconstruction has some theoretical disadvantages, particularly, unnecessary abandoning of useful main arteries, undesirable flow patterns and the possible descent of debris from the by-passed portion of artery. An oblique end-to-end technique can avoid these undesirable features and also avoid the creation of an over-sized vessel at the site of end-to-side anastomosis. It is suggested that the least procedure compatible with success should be used in arterial reconstruction in the lower limb and an ascending range of options open to the surgeon is given.