Occurrence of sectoral choroidal occlusive vasculopathy and retinal arteriolar embolization after superselective ophthalmic artery chemotherapy for advanced intraocular retinoblastoma.

BACKGROUND:: Superselective ophthalmic artery chemotherapy (SOAC) has recently been proposed as an alternative to intravenous chemoreduction for advanced intraocular retinoblastoma. Preliminary results appear promising in terms of tumor control and eye conservation, but little is known regarding ocular toxicity and visual prognosis. In this study, we report on the vascular adverse effects observed in our initial cohort of 13 patients. METHODS:: The charts of 13 consecutive patients with retinoblastoma who received a total of 30 injections (up to 3 injections of a single agent per patient at 3-week interval) of melphalan (0.35 mg/kg) in the ophthalmic artery between November 2008 and June 2010 were retrospectively reviewed. RetCam fundus photography and fluorescein angiography were performed at presentation and before each injection. Vision was assessed at the latest visit. RESULTS:: Enucleation and external beam radiotherapy could be avoided in all cases but one, with a mean follow-up of 7 months. Sectoral choroidal occlusive vasculopathy leading to chorioretinal atrophy was observed temporally in 2 eyes (15%) 3 weeks to 6 weeks after the beginning of SOAC and retinal arteriolar emboli in 1 eye 2 weeks after injection. There was no stroke or other clinically significant systemic side effects except a peroperative transient spasm of the internal carotid artery in one patient. Vision ranged between 20/1600 and 20/32 depending on the status of the macula. CONCLUSION:: Superselective ophthalmic artery chemotherapy was effective in all patients with no stroke or other systemic vascular complications. Unlike intravenous chemoreduction, SOAC is associated with potentially sight-threatening adverse effects, such as severe chorioretinal atrophy secondary to subacute choroidal occlusive vasculopathy or central retinal artery embolism, not to mention the risk of ophthalmic artery obstruction, which was not observed in this series. Further analysis of the risks and benefits of SOAC will define its role within the therapeutic arsenal. Meanwhile, we suggest that SOAC should be given in one eye only and restricted to advanced cases of retinoblastoma, as an alternative to enucleation and/or external beam radiotherapy.

Ulrike Meinhofin tie terroristiksi: kaupunkisissitaktiikka poliittisen intervention välineenä

Abstract: Ulrike Meinhof's way to terrorism: the urban guerilla tactics as a means of political intervention

Vitamin D deficiency and a CYP27B1-1260 promoter polymorphism are associated with chronic hepatitis C and poor response to interferon-alfa based therapy.

BACKGROUND & AIMS: Vitamin D is an important immune modulator and preliminary data indicated an association between vitamin D deficiency and sustained virologic response (SVR) rates in hepatitis C virus (HCV) genotype 1 patients. We, therefore, performed a comprehensive analysis on the impact of vitamin D serum levels and of genetic polymorphisms with functional relevance within the vitamin D cascade on chronic hepatitis C and its treatment. METHODS: Vitamin D serum levels, genetic polymorphisms within the vitamin D receptor and 1α-hydroxylase were determined in a cohort of 468 HCV genotype 1, 2, and 3 infected patients who were treated with interferon-alfa based regimens. RESULTS: Chronic hepatitis C was associated with a high incidence of severe vitamin D deficiency compared to controls (25(OH)D(3)<10 ng/ml in 25% versus 12%, p<0.00001). 25(OH)D(3) deficiency correlated with SVR in HCV genotype 2 and 3 patients (50% and 81% SVR for patients with and without severe vitamin D deficiency, respectively, p<0.0001). In addition, the CYP27B1-1260 promoter polymorphism rs10877012 had substantial impact on 1,25-dihydroxyvitamin D serum levels (72, 61, and 60 pmol/ml for rs10877012 AA, AC, and CC, respectively, p=0.04) and on SVR rates in HCV genotype 1, 2, and 3 infected patients (77% and 65% versus 42% for rs10877012 AA, AC, and CC, respectively, p=0.02). CONCLUSIONS: Chronic hepatitis C virus infection is associated with vitamin D deficiency. Reduced 25-hydroxyvitamin D levels and CYP27B1-1260 promoter polymorphism leading to reduced 1,25-dihydroxyvitamin D levels are associated with failure to achieve SVR in HCV genotype 1, 2, and 3 infected patients.

Cell-mediated immunity to predict cytomegalovirus disease in high-risk solid organ transplant recipients.

Late-onset cytomegalovirus (CMV) disease commonly occurs after discontinuation of antiviral prophylaxis. We determined the utility of testing CD8+ T-cell response against CMV as a predictor of late-onset CMV disease after a standard course of antiviral prophylaxis. Transplant patients at high-risk for CMV disease were enrolled. CD8+ T-cell-mediated immunity (CMI) was tested using the QuantiFERON-CMV assay at baseline, 1, 2 and 3 months posttransplant by measurement of interferon-gamma response to whole blood stimulation with a 21-peptide pool. The primary outcome was the ability of CMI testing to predict CMV disease in the first 6 months posttransplant. There were 108 evaluable patients (D+/R+ n = 39; D-/R+ n = 34; D+/R- n = 35) of whom 18 (16.7%) developed symptomatic CMV disease. At the end of prophylaxis, CMI was detectable in 38/108 (35.2%) patients (cutoff 0.1 IU/mL interferon-gamma). CMV disease occurred in 2/38 (5.3%) patients with a detectable interferon-gamma response versus 16/70 (22.9%) patients with a negative response; p = 0.038. In the subgroup of D+/R- patients, CMV disease occurred in 1/10 (10.0%) patients with a detectable interferon-gamma response (cutoff 0.1 IU/mL) versus 10/25 (40.0%) patients with a negative CMI, p = 0.12. Monitoring of CMI may be useful for predicting late-onset CMV disease.

anonymi tractatus de magia, sive de philosophia naturali, in quo praesertim de astrologia judiciaria disseritur.

Colbertinus

Francisci Maurolyci, Siculi, demonstratio algebrae ; sive potiùs, regulae calculi litteralis ad inveniendum terminum quemlibet proportionis geometricè continuae.

Colbertinus

Euclidis elementorum libri decem priores, à Francisco Maurolyco in epitomen contracti.

Colbertinus

1.° Francisci Maurolyci demonstrationes in duodecimum librum Euclidis elementorum. — 2.° Ejusdem modus fabricandi astrolabium, cum demonstrationibus geometricis. — 3.° Ejusdem opusculum de fabrica et usu quadrati horarii, ad omnem horisontem accommodati. — 4.° Collectanea ex fabula et historia antiqua.

Colbertinus

1.° Sereni cylindricorum libri duo : Francisco Maurolyco interprete. — 2.° Archimedis libellus de circuli dimensione : eodem Maurolyco interprete.

Colbertinus

1.° Francisci Maurolyci de centro solidi parabolae demonstratio : praemittuntur catalogus ejusdem operum et observationes de ordine quo singula legenda sunt. — 2.° Descriptio hyperbolarum contrapositarum, diametrorum, tangentium, linearum continuè proportionalium et triangulorum aequalium : authore eodem. — 3.° Ejusdem algebra, sive potiùs, regulae calculi litteralis ad inveniendum terminum quemlibet proportionis geometricè continuae.

Colbertinus

1.° Theonis, ex traditione Pappi, datorum libri duo : interprete Francisco Maurolyco ; cum ejusdem Maurolyci additionibus. — 2.° Euclidis phaenomena, cum expositione Maurolyci.

Colbertinus

1.° Autolyci liber de sphaera quae movetur, cum interpretatione et commentario Francisci Maurolyci. — 2.° Theodosii de habitationibus, de noctibus ac diebus libri duo, cum ejusdem Maurolyci interpretatione et notis. — 3.° Autolyci de vario ortu et occasu siderum non errantium libri duo : interprete Francisco Maurolyco.

Colbertinus

radices motuum, latera diametrorum, distantiae tabellae, cum regulis ad calculum pertinentibus et demonstrationibus : authore Francisco Maurolyco.

Colbertinus

Hieronymi Cardani, Mediolanensis Medici, commentariorum in Euclidis elementa libri novem.

Mazarinaeus

1.° Francisci Barocii, Patricii Veneti, lectiones in Procli commentarios in primum Euclidis elementorum librum : finis desideratur ; praemittuntur Christoph. Clavii, Fran. Barocii et aliorum epistolae nonnullae : italico idiomate. — 2.° Excerpta è sancto Augustino et Lud. Vive de Sibylla Erythrea.

D. Dufresne