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Objective: We investigated the in-hospital and long-term follow-up (mean 21 months) results of patients with and without anemia on admission and who have undergone primary angioplasty for ST elevation myocardial infarction (STEMI)., Study Design: A total of 2509 patients (616 patients with anemia on admission, 1893 patients without anemia on admission), who were treated with primary angioplasty due to STEMI, were included in this study. Demographics and basic clinical features of the patients, outcomes of the primary angioplasty procedures, and clinical course of the patients during and a mean period of 21-month follow-up after hospitalization were retrospectively evaluated. All the parameters were compared between anemic and nonanemic groups., Results: The mean age of the patients in anemic group was found to be higher than nonanemic group (61.5 ± 11.4 vs. 54.8 ± 11.4, P<0.001). The rates of death, major cardiac events, and severe cardiac insufficiency were significantly higher in anemic patients during hospitalization period. Moreover, frequency of death was also higher in anemic patients when compared with the nonanemic ones after a mean follow-up period of 21 months (P<0.001). Anemia on admission is an independent predictive factor for mortality in patients with STEMI who were treated with primary angioplasty (odds ratio: 2.2; 95% confidence interval: 1.2-4.0; P<0.009)., Conclusion: Patients with anemia on admission initially have high-risk profiles regarding their worse clinical outcomes during and 21 months after hospitalization. In accordance with the suggestion of the evidence-based medicine we conclude that etiology of anemia should be meticulously investigated and the oxygenization of the tissue should be provided with the appropriate treatment.

Purpose: To induce a posterior vitreous detachment (PVD) in porcine and human cadaver eyes in vitro with Dispase (Gibco, Grand Island, NY)., Methods: Dispase (0.5 mL) was injected into the vitreous cavity of enucleated porcine (0.05-25 U/mL) and human (5 U/mL) eyes. After incubation at 37 degrees C for 15-120 minutes, the globes were hemisected and the extent of PVD was graded as complete, partial, or absent. The structural integrity of the retina was estimated by measuring the elastic constant and maximal stretching before fracture. Retinal cell viability was determined by an intracellular esterase assay. Light, transmission, and scanning electron microscopy were performed to examine the ultrastructure of the vitreoretinal interface., Results: After 15 minutes, a partial or total PVD was present in 7/10, 8/10, or 9/10 enucleated porcine eyes incubated with 1, 5, or 10 U/mL Dispase, respectively, versus 3/10 control eyes (P < 0.05). A partial or complete PVD was present in 3/5, 4/5, 5/5, or 14/15 porcine eyes after 15, 30, 60, or 120 minutes of treatment with 0.1 U/mL Dispase, respectively. Similarly, 19/20 human cadaver eyes developed a complete and 1/20 an incomplete PVD after incubation with 5 U/mL Dispase for 15 minutes. Microscopy demonstrated that Dispase cleaved the attachment of the posterior hyaloid to the internal limiting membrane with minimal damage to the inner retina. Retinal cell viability and the mechanical properties of the retina were similar for Dispase-treated and control eyes., Conclusion: Dispase disrupts the attachment of the posterior hyaloid to the inner limiting membrane with minor morphologic changes in the inner retina. The enzyme may be useful in removing cortical vitreous during vitreous surgery.