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AimsTo define and quantify the upper lid contour by adapting Bézier curves with a newly developed software in normal subjects, assessing their reliability.MethodsFifty eyes of 50 healthy patients with no ocular pathology were included in this study from October 2020 to November 2020. All measurements were performed on Bézier curves adjusted to the upper lid contour. An original software was used to measure the radial and vertical midpupil-to-lid margin distances (MPLD), temporal-to-nasal (T/N) ratios, contour peak location and grade of superposition (GS) and asymmetry (GA) indexes. We calculated differences in the variables measured regarding age, gender or the side of the eye being assessed.ResultsThe mean Bézier curve showed an excellent level of inter-rater reliability (intraclass correlation coefficient of 0.99). The median GS index of each eyelid to the mean Bézier curve was 95.4%, 8.5 IQR, and the median GA index was 3%, 3.4 IQR. The mean contour peak location was −0.35 mm, SD 0.45. Overall, the mean central MPLD was 4.1 mm, SD 0.6. No significant differences were found between male and female patients in variables derived from Bézier curves.ConclusionBézier curves may become a very useful tool for the assessment of upper lid contour, contour peak and symmetry. GS and GA indexes, along with the T/N area ratio are potential outcomes for this purpose. All current variables can be obtained just from one single Bézier curve measurement. Our results offer an in-depth exhaustive description of these variables and their distribution in the normal population.

Purpose To assess the effectiveness and safety of same-site trabeculectomy (TRAB) with mitomycin C (MMC) and Ologen™ (Aeon Astron Europe BV. Leiden, The Netherlands) in patients with a failed non-penetrating deep sclerectomy (NPDS).Methods A retrospective study of 24 consecutive eyes (22 patients) undergoing reintervention by same-site TRAB with at least one-year follow-up after failed NPDS. Mean visual acuity (VA), intraocular pressure (IOP) and use of glaucoma medications were compared before and one year after surgery. Early and late postoperative complications were registered. Kaplan-Meier survival analysis was performed according to four levels of success criteria.Results Overall the mean IOP reduced significantly (24.9 ± 7.1 vs. 14.4 ± 4.5 mmHg; p< 0.001), and the number of glaucoma medications (2.80 ± 1.01 vs. 0.55 ± 0.94; p< 0.001) significantly decreased, one year after surgery. The mean VA remained stable one year after surgery (p= 0.516). Hypotony, defined as IOP ≤ 5 mmHg, in the early postoperative period was observed in 62.5% of eyes, but only in 2 patients (8.33%) in the long term. The mean survival time ranged from 10 months (CI 95% 5–15) to 29 months (CI 95%: 26–32) according to the most stringent and lenient success criteria respectively.Conclusion Same-site TRAB augmented with MMC and Ologen™ may provide an effective, safe and lasting alternative following failed NPDS, especially when sparing of the conjunctiva is highly desirable. Postoperative hypotony is the most common postoperative complication.

La ascitis es la complicación más frecuente en los pacientes con cirrosis hepática e hipertensión portal, y suele ser la primera manifestación de la enfermedad en la mayoría de los casos. El desarrollo de ascitis en estos enfermos es consecuencia de una importante alteración de la hemodinámica sistémica y esplácnica y de la función renal. Dado que las alteraciones estructurales hepáticas son usualmente irreversibles, la mayoría de los pacientes cirróticos desarrollan episodios repetidos de ascitis durante el curso de la enfermedad que, en ocasiones, pueden ser persistentes o de difícil control a pesar de ser tratados de forma continua. El desarrollo de ascitis en la cirrosis es un signo de mal pronóstico. La probabilidad de supervivencia uno y cinco años después del primer episodio de ascitis es del 50 y 20%, respectivamente. Esta corta supervivencia debe ser tenida en cuenta al analizar el tratamiento de estos enfermos, especialmente en relación con la indicación del trasplante hepático como tratamiento definitivo y curativo.

La insuficiencia renal aguda es una complicación muy frecuente que comporta muy mal pronóstico en pacientes con cirrosis hepática. Su clasificación precoz y precisa con los criterios AKI (Acute Kidney -njury), modificados para pacientes con cirrosis hepática, y el correcto diagnóstico diferencial es muy importante para proporcionar un tratamiento adecuado. Esta tarea no siempre es fácil y requiere una cuidosa evaluación. Los pacientes con estadio AKI ≥ 1B tienen peor pronóstico, con lo que precisan de un tratamiento más específico. El diagnóstico diferencial entre síndrome hepatorrenal (SHR) y la necrosis tubular aguda (NTA) es de vital importancia, ya que son las dos etiologías con mayor mortalidad y con un tratamiento específico para cada tipo.

La cirrosis hepática es una enfermedad que puede afectar a múltiples órganos. Pese a su menor frecuencia, estas manifestaciones extrahepáticas pueden condicionar la evolución clínica y el pronóstico de los pacientes, incluso con mayor gravedad que las complicaciones propias de la cirrosis. Las manifestaciones de la afectación cardíaca son variadas y pueden pasar desapercibidas hasta encontrar una situación de estrés, por lo que ante una intervención quirúrgica, es precisa su sospecha y evaluación cuidadosa. Ante la presencia de cirrosis con disnea debe sospecharse la existencia de afectación pulmonar. Las dos manifestaciones más características incluyen el síndrome hepatopulmonar y la hipertensión portopulmonar y alteraciones nutricionales como la malnutrición y la sarcopenia. Un correcto estado nutricional mejora la evolución y el pronóstico de estos pacientes.

El desarrollo de hipertensión portal (HTP) está unido, inequívocamente, a la cirrosis hepática evolucionada, y siendo la causa directa de las complicaciones típicas de la cirrosis como el desarrollo de varices esofágicas y gástricas, la gastropatía de la HTP, el síndrome hepatorrenal, la peritonitis bacteriana espontánea, la ascitis, la pancitopenia por hiperesplenismo y la encefalopatía portosistémica. La presencia de cualquiera de estas complicaciones marca la transición de la fase compensada a la descompen- sada de la enfermedad, lo que conlleva un cambio drástico en el pronóstico y un empeoramiento significativo de la supervivencia. En la génesis y mantenimiento de la HTP asociada a la cirrosis hepática existen dos mecanismos que actúan de manera sinérgica, por una parte, se produce un aumento de la resistencia vascular intrahepática, que da lugar a la formación de colaterales y la aparición del segundo mecanismo que es el hiperaflujo esplácnico. El mejor conocimiento de la fisiopatología de la hipertensión portal en la cirrosis hepática ha permitido el desarrollo de fármacos dirigidos a bloquear estos mecanismos, que se refleja en una mejoría de la morbimortalidad en estos pacientes.

Ab initio calculations were carried out for isogyric reactions involving the third row elements, Ga, Ge, As, Se, and Br. Geometries of all the reactants and products were optimized at the HF, MP2, and B3LYP levels of theory using the 6-31G(d) and 6-31G(d,p) basis sets. For molecules containing third row elements geometries, frequencies and thermodynamic properties were calculated using both the standard 6-31G and the Binning-Curtiss (BC6-31G) basis sets. In order to determine the performance of these basis sets, the calculated thermodynamic properties were compared to G3MP2 values and where possible to experimental values. Geometries and frequencies calculated with the standard 6-31G and the BC6-31G basis sets were found to differ significantly. Frequencies calculated with the standard 6-31G basis set were generally in better agreement with the experimental values (MAD40.1 cm-1at B3LYP/6-31G(d,p) and 94.2 cm-1at MP2/6-31G(d,p) for unscaled frequencies and 29.6 cm-1and 24.4 cm-1, respectively, for scaled frequencies). For all the reactions investigated, the thermodynamic properties calculated with the standard 6-31G basis set were found to consistently be in better agreement with the G3MP2 and the available experimental results. However, the BC6-31G basis set performs poorly for the reactions involving both second and third row elements. Since, in general, the standard 6-31G basis set performs well for all the reactions, we recommend that the standard 6-31G basis set be used for calculations involving third row elements. Using G3MP2 enthalpies of reaction and available experimental heats of formation (Hf), previously unknown Hffor CH3SeH, SiH3SeH, CH3AsH2, SiH3AsH2, CH3GeH3, and SiH3GeH3were found to be 18.3, 18.0, 38.4, 82.4, 41.9, and 117.4 kJ mol-1, respectively.

The influence of stress relieving and ageing treatments in the range 600 to 900° C on the phase transformations and change in room temperature impact properties has been studied for two manual metal arc 17-8-2 weld metals. The transformation of thed-ferrite in the range 600 to 800° C was found to conform to a classical Johnson-Mehl equation; the initial precipitates were M23C6 carbides followed by the intermetallic?-phase. At higher temperatures a slower transformation rate was found suggesting a “C” curve type of behaviour and the dominant intermetallic phase changed tos. Room temperature impact toughness values were found to change with ageing time. Below 800° C there was a consistent fall in these values which became very marked when the?-phase developed at the?/d-boundaries, Above 800° C, spherodization of the carbides and intermetallic phases delayed the fall in the impact values, and led to significant increases in the early stages of ageing. Scanning electron microscopy confirmed that the change from ductile to brittle fracture mode was normally associated with the development of thes and? phases, but at 600° C the fall in impact properties could be atrributed to carbide development.

Three new species of Rubus subgenus Rubus series Pallidi from Spain are described, mapped and illustrated: R. cyclops, R. castroviejoi and R. urbionicus. Copyright 1994, 1999 Academic Press

Monasterio‐Huelin, E. & Castroviejo, S.: Typification of the names of Iberian Rubusspecies described by Sampaio. – Taxon42: 601–608. 1993. – ISSN 0040‐0262. Lectotypes are designated for the 13 binomials validly published by Sampaio in Rubus, based on the study of the original material in Sampaio's herbarium in Oporto (PO) and of duplicates present in Madrid (MA). Of the 13 named species of Rubusdescribed by Sampaio, 5 (R. sampaioanus, R. vagabundus, R. peratticus, R. henriquesiiand R. brigantinus) are considered autonomous (regional), while the rest appear to be merely local species.

The expression of HLA class I antigens was studied in 99 primary tumour (colorectal, gastric and laryngeal carcinomas) and 57 autologous metastases using immunohistological techniques and monoclonal antibodies against class I monomorphic determinants, HLA-B isotypic determinants and HLA polymorphic determinants. Fourteen per cent of colorectal, 9.6% of gastric and 20% of laryngeal carcinomas completely lacked class I molecules. Selective losses of HLA-B antigens were also detected in 8.8, 3.4 and 5.8% of these tumours respectively. Taking into account complete and selective loss of HLA-B the average alteration in the class I molecules expression totalled 21%. The comparison of class I expression between primary tumours and autologous metastases showed differences in 24% of the patients. These differences consisted mainly in a decrease of class I expression by metastases. Nevertheless, four types of divergence were detected in laryngeal carcinomas, namely: +/-, +/+, -/+, -/-. In addition, a clear correlation between degree of differentiation and class I expression was observed in laryngeal tumours. Finally, when class I gene RFLPs were compared with DNA from 15 tumours and autologous normal mucosa or peripheral lymphocytes, no differences were detected between these samples.

A palynological study using LM and SEM was made of the morphology, ornamentation, apertural system and structure of the pollen wall, of the 18 species of the genus Rubus which are present in the Iberian Peninsula. We demonstrate: a) the stenopalynous character of the genus (isopolar, subprolate, 3-lobate, 3-zonocolporate and striate-perforate, except for R. genevierii whose ornamentation is striate-gemmate-perforate and with a striated margin); b) the lalongate shape of the endoaperture, due to the disappearance or thinning of the nexine; and c) the existence of two structural types, Type I granular and Type II columellar with clearly-defined columellar spaces or compact without intercolumellar spaces.

HLA class I and II expression was studied on 244 (177 primary and 67 metastatic) solid human tumours of different origin. Alkaline immunophosphatase (APAAP) and immunoperoxidase were used on cryostatic sections to stain MHC antigens. Monomorphic MoAbs were used against class I heavy chain, β2-microglobulin, DR, DQ and DP molecules. Class I expression was homogeneous on colon, melanoma and epidermoidal primitive tumours. Loss of HLA class I antigens was more frequent on basal cell carcinomas and sarcomas and was related to tumour differentiation on larynx carcinoma. Class I expression was heterogeneous on breast, larynx and stomach primitive neoplasias. Class I negative tumours were more frequent on metastatic than on primitive melanomas. Divergence of class I between primary tumours and autologous metastases was observed on melanomas, larynx and colorectal carcinomas. Class II expression was heterogeneous on all tumours and in a large number of cases was associated with high intensity of leukocytic infiltrate. HLA-DR expression was higher than HLA-DP and HLA-DQ (DR>DP>DQ) and was related to tumour progression. Four human tumour cell lines were modulated with recombinant interferon-γ for HLA class I and II antigens. Different HLA profiles were obtained: increased class I and II expression, increased class II or a low response. Finally, class I genes from 22 tumours were compared with autologous normal cells by Southern blot analysis: 12 tumours were class I positive and 10 negative. No clear differences in RFLP were observed that could be associated with class I rearrangement. The results are discussed in relation to the role that histocompatibility antigens may play in tumour progression and invasiveness.

The publication of Mr Norman Longmate’s book King Cholerain November 1966 served as a reminder of the terrible scourge which afflicted this country on no less than four separate occasions during the nineteenth century. While this volume was, no doubt—as the ‘blurb’ on its dust-jacket affirms—‘an important contribution to social history’, so far as the part which the Church played during those critical years, the half was not told in its pages. In this short paper it will be my task to try to repair this omission in regard to just one of the four major outbreaks of the disease in England, the last in fact, that of the year 1866; and to say something of the response made by churchmen and women to the cholera outbreak of a century ago.

Gene therapy for Niemann-Pick type A disease is safe in nonhuman primates and has therapeutic effects in a mouse model.