Search

The elimination kinetics and penetration of ceftazidime into skin blister and lymphatic fluid were studied in nine healthy volunteers following a 1 g iv bolus injection. From the concentration time curve in plasma the following pharmacokinetic parameters (mean±S.D.) were calculated: elimination half-life 1.85±0.33 h; area under the curves 127±12 mg. h/l; apparent volume of distribution: 21.1±2.61; total plasma clearance: 133±13 ml/min and renal clearance: 109±7 ml/min. Urine recovery after 8 h was 82% of the administered dose. Nearly the same elimination rate constant, half-life and area under the curve were demonstrated for blister fluid and lymph.The penetration of ceftazidime into cerebrospinal fluid (n = 19), aqueous humour (n = 21) and pleural effusions (n = 5) were studied in patients after a 2 g iv bolus injection. In patients with normal meninges (n = 14) the penetration was poor: the concentrations were less than 1 mg/1. In patients with meningitis (n = 5) levels of 18, 17, 16, 1 and 0.8 mg/l were found. Aqueous humour penetration was satisfactory, and a mean concentration of 11±4 mg/l corresponding to a penetration ratio of 19% was found. The penetration of ceftazidime into large pleural effusions was also good with concentrations from 17±3 to 28±2 mg/l, corresponding to a mean penetration ratio of 38%. [ABSTRACT FROM PUBLISHER]

Context: Autoimmune thyroid disease is the most common endocrine comorbidity in autoimmune Addison disease (AAD), but detailed investigations of prevalence and clinical course are lacking., Objective: This work aimed to provide comprehensive epidemiological and clinical data on autoimmune thyroid disorders in AAD., Methods: A nationwide registry-based study including 442 patients with AAD and autoimmune thyroid disease were identified through the Norwegian National Registry of Autoimmune Diseases., Results: Of 912 registered AAD patients, 442 (48%) were diagnosed with autoimmune thyroid disease. A total of 380 (42%) had autoimmune hypothyroidism. Of the 203 with available thyroid function tests at time of diagnosis, 20% had overt hypothyroidism, 73% had subclinical hypothyroidism, and 7% had thyroid levels in the normal range. Negative thyroid peroxidase antibodies was found in 32%. Ninety-eight percent were treated with levothyroxine, 5% with combination therapy with liothyronine or thyroid extracts, and 1% were observed without treatment. Seventy-eight patients (9%) were diagnosed with Graves disease (GD), of whom 16 (21%) were diagnosed with autoimmune hypothyroidism either before onset or after remission of GD. At the end of follow-up, 33% had normal thyroid hormone levels without antithyroid-drugs or levothyroxine treatment. The remaining had either active disease (5%), had undergone ablative treatment (41%), or had developed autoimmune hypothyroidism (21%)., Conclusion: The true prevalence of hypothyroidism in AAD is lower than reported in the current literature. Careful consideration of the indication to start thyroxin therapy is warranted. Long-term remission rates in GD patients with AAD are comparable to recent reports on long-term follow-up of patients without AAD., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.)

Purpose: The present study was to investigate, using cell kinetic methods, whether previous excimer laser treatment affected healing of later corneal epithelial erosions., Methods: The right eyes of rats underwent central excimer corneal stromal-epithelial ablations (ArF 193 nm, 228 pulses, diameter 3,5 mm, 17,3 mJ per pulse, depth about one third of corneal thickness) and were allowed to heal for 15 weeks. Then central circular epithelial abrasions (diameter 3 mm), using N-Heptanol and mechanical debridement, were made on both corneas. The rats were killed 1,2,4 and 6 days after the last treatment. The central stromal thickness, the epithelial cell density, the labelling index (LI) and the mitotic rate (MR) of the peripheral, the midperipheral and the central areas of the corneal epithelium were calculated for each timepoint., Results: The central stromal thickness increased equally in the two groups the first day after making the erosion, normalising in both groups during the following days. The corneal epithelium was restored at the same rate in both groups. The cell number per microscopic visual field, the LI and the MR were very similar for the two groups at all timepoints., Conclusion: Previous excimer laser treatment does not seem to interfere with healing of later epithelial erosions, when studied with cell kinetic methods.

The hypothesis that ocular pseudo-exfoliation syndrome is part of a generalized disorder has been tested by suggesting that subjects having this syndrome would have increased mortality. However, no association was found between presence of ocular pseudo-exfoliation syndrome and mortality.

Rats with excimer corneal ablations (ArF 193 nm, 228 pulses, diameter 3,5 mm, 17.3 mJ per pulse, depth about 1/2 of corneal thickness) in one eye were killed 1, 2, 4, 6 and 13 days after treatment. The other eye served as control. The cell number per microscopic vision field, the labelling index (LI) and the mitotic rate (MR) were calculated for the peripheral, midperipheral and central areas of the corneal epithelium. The cell number showed a uniform depression in the remaining corneal epithelium at Day 1, normalizing from the centre to the periphery. The LI was only significantly increased at Day 1, while the MR was statistically significantly increased peripherally at Day 2 and in all areas at Day 6. However, when the corneal epithelium was evaluated as a whole, the MR was significantly increased at days 1, 2 and 6. The proliferative response of the epithelium was very homogenous irregardless of the distance to the original lesion. Both the migratory and the proliferative phases of the healing process seemed to be delayed when compared to the healing of pure epithelial wounds. However, the initiation of an increase in DNA synthesis seems not to be delayed, indicating that it is primarily the G2 phase that has been prolonged with this ablation procedure. The stromal thickness was increased from about one half of the normal values immediately after the treatment to above normal values at Day 4, thereafter decreasing to normal values at Day 13. Thus, the regenerative ability of the stroma is more pronounced in rats than in humans, but also in humans regeneration of the stroma can possibly explain the regression of the myopic shift seen some time after excimer laser treatment.

The probability of having glaucoma may be expressed by the quotient p = (number of eyes with glaucomatous damage)/(total number of eyes). p has been calculated for different IOP levels, within a total population and also within groups with and without pseudo-exfoliation (PE). The resulting quotients were plotted versus IOP. Random irregularities were reduced by regression analysis, using the equation for the logistic distribution. The resulting sigmoid curves demonstrated that the probability p of having glaucomatous damage at a certain IOP is highest in the PE group. In the total material, the glaucoma probability p was 0.5 at IOP = 27.1 mmHg, and at IOP = 25.3 and 28.0 mmHg in the groups with and without PE, respectively. The frequency distributions of the glaucoma tolerance limit have been computed from the glaucoma probability curves.

The results of a population-based (age greater than or equal to 65 years) examination of the frequency distribution of IOP are reported. 3726 eyes in 1887 individuals were included in the examination. By consistent use of conventional, well-defined criteria, glaucoma was diagnosed in 6.4% of the individual eyes. In the total material, the average IOP was 18.0 mmHg. Average IOP was 28.7 mmHg in eyes with glaucomatous damage, vs 17.2 mmHg in the normal eyes. Variance of IOP was much higher in the glaucoma group as compared with the normal group. The IOP frequency distribution curve did not fit with a Gaussian curve; it was asymmetric, skewed to the right. The distribution curve obtained by plotting the recorded frequencies was disturbed by irrelevant irregularities, both random and systematic. The irregularities could be evened out by the application of regression analysis, using the equation for the gamma distribution. The IOP frequency distribution is well represented by a gamma distribution curve. The fit is improved by excluding eyes with extremely high and low IOP.

The probability of having glaucoma is indicated by the quotient (number of eyes with glaucoma)/(number of eyes in the total population). This quotient was calculated for each value of IOP. The number of eyes at each IOP value was taken from IOP frequency distribution curves for glaucomatous and normal eyes, calculated from values obtained by a population survey. By plotting the probability of having glaucoma vs IOP, a sigmoid curve was obtained. The curve indicates that while the glaucoma probability is near zero at IOP = 18 mmHg, it is 0.5 at 27-28 mmHg, and the probability approaches 1, i.e. certainty, at an IOP around 35 mmHg. The frequency distribution of the tolerance limit of IOP was calculated by derivation of this curve. The distribution of IOP tolerance limit was close to a normal distribution with average = 27.9 mmHg and standard deviation = 3.2 mmHg.

On the basis of a glaucoma survey in a total population greater than or equal to 65 years of age, the IOP in eyes with and without pseudo-exfoliation (PE) has been compared. The average IOP was 22.2 mmHg in eyes with PE versus 17.4 in eyes without. The corresponding averages in eyes without glaucomatous damage were 18.6 and 17.1 mmHg, and in eyes with glaucoma 31.5 and 25.5 mmHg. The IOP elevation connected with the PE process was 4.8, 1.5, and 6.0 mmHg in the total, normal and glaucomatous population, respectively. The IOP frequency distribution curves of these 3 groups were compared. The right shift of the distribution curves of the PE groups was more pronounced at high pressure levels. The PE process seems to elevate the IOP particularly in eyes with a high IOP, which is in correspondence with hydrodynamical laws. At a certain IOP, the probability of having glaucomatous damage was higher in eyes with PE than in those without, indicating an increased vulnerability of PE eyes to an elevated IOP. PE may be a glaucoma risk factor also on its own, i.e. independent of the pressure elevation connected with this syndrome.

The records of all patients with simple and capsular glaucoma who visited our clinic in the period from 1.1.1972 to 31.12.1982, and who were alive at the 31.12.82, have been evaluated. In the population older than 49 years 0.54% had simple and 0.74% had capsular glaucoma, equally distributed on men and women. In average near 60% had capsular glaucoma, with great variation in different municipalities. Highest figures were found in a belt reaching from the coast into the inland. Both simple and capsular glaucoma showed increasing occurrence till 75-80 years, thereafter the curves decline.

Acute endophthalmitis was unilaterally induced in 8 rabbits by intravitreal injection of 5 micrograms Escherichia coli endotoxin. A reproducible increase in aqueous humour polymorphonuclear neutrophils and total protein content was observed after 24 h (mean +/- SD: 2400 +/- 274 X 10(6)/l and 3.7 +/- 0.4 g/l, respectively). In the opposite eye only minor changes occurred, making it suitable as a paired control. The intraocular penetration of ceftazidime was then studied in 30 rabbits after i.v. injection of 50 mg/kg body weight. The mean penetration into aqueous humour of the eyes with and without endophthalmitis was 64 and 10%, respectively. In the vitreous body the corresponding penetration was 5 and 1%. The concentration of ceftazidime achieved in the intraocular structures was sufficient to inhibit the growth of pathogens, i.e. Enterobacteriaceae, commonly responsible for intraocular infections.

100 outpatient and 143 inpatient intracapsular cataract extractions with anterior chamber lens implantation were examined 6 months post-operatively. 74 (74%) in the former and 107 (75%) in the latter achieved visual acuity greater than or equal to 0.5. Excluding non-surgical pathology, 93% in the outpatient group and 98% in the inpatient group had a visual acuity greater than or equal to 0.5 (P = 0.12). There were no significant differences in post-operative complications except for the incidence of cystoid macular edema. Six (6%) of the outpatient and 1 (0.7%) of the inpatient procedures had cystoid macular edema that resulted in a visual acuity below 0.5 (P = 0.02).

The penetration of ceftazidime into the aqueous humour and the vitreous body of the rabbit eye, after intravenous (i.v.) bolus or subconjunctival injection, was investigated. A dose of 50 mg/kg body weight was administered. After i.v. administration the mean penetration into the aqueous humour was 13% of the plasma values. After subconjunctival injection into the left eye, mean levels of 14% and 25% of the plasma concentrations were found in the right and left eye, respectively. The concentrations in the vitreous body were in all cases below the ceftazidime detection limit (1 mg/l), i.e. less than 1% of the plasma levels. The mean penetration of ceftazidime into human aqueous humour (measured during cataract extraction) was 19% after 2 g i.v. bolus injection. Ceftazidime levels sufficient to inhibit the growth of most pathogens commonly responsible for intraocular infections, including Pseudomonas spp., were consistently found in the aqueous humour. However, inadequate concentrations were achieved in the vitreous body.

An epidemiological eye study has been performed in three separate municipalities in the county of South-Trøndelag, Norway. The prevalence of pseudoexfoliation syndrome turned out to be 10.2%, 21.0%, and 19.6% in the respective areas, stating beyond doubt that there are considerable geographic variations in the distribution of this syndrome.

200 good readers and 41 poor readers selected from 718 pupils in a primary school, grade 1-6 were examined in respect of stereopsis, visual acuity, phorias, tropias, fusional breakpoint, fusional amplitude and objective refraction. No statistical difference was found between the 2 reader groups, and the need for optical aid was of the same order. 80 of the 241 children had unnecessary glasses, and many of those who needed spectacles were improperly aided.

ABO-blood groups and Rh-factor (D-antigen) were determined in 236 patients with POAG, 104 simple and 132 capsular glaucoma. There was a statistical significant difference in the ABO-distribution between the two glaucoma subgroups, and also between the capsular-group and our control material. The simplex-group did not differ from the control material in this respect. For the Rh-group (D-antigen) no differences were found, neither between the two glaucoma subgroups nor between each of them and a reference material.

180 eyes of 97 patients with primary open angle glaucoma and IOP greater than 22 mm were treated for more than 3 years with timolol-maleate. 130 eyes had glaucoma simplex, and 50 eyes had glaucoma capsulare. With timolol maleate as the only medication after 3 years, the IOP was controlled in 33% of the glaucoma simplex group, and in 8% of the glaucoma capsulare group. No serious local or systemic side-effects were observed.

Serum, aqueous humour, and lens ascorbic acid levels were determined by high-performance liquid chromatography in cataract-, closed-angle glaucoma-, and aphakic patients. The total number of 108 patients were subdivided into different groups. In several groups the pre-operative serum and aqueous amounts were tested, whereafter patients in some groups were loaded with ascorbic acid orally. Finally, a second test was performed on samples taken during operation. It turned out that the ascorbic acid concentration mechanism in cataractous eyes needed more than 12 h for maximum reaction on the loading stimulus. The slow reaction is surprising compared to other species, and it may reflect an affection of the secretory process itself in this disease.

This study was performed in order to develop a method for studying blood flow in the ophthalmic circulation. Using a pulsed doppler system utilizing an ultrasonic frequency of 10 MHz, blood flow velocities have been measured in the ophthalmic artery and in the arteries behind the eyeball (lateral posterior ciliary arteries) in 40 normal subjects. The mean of the peak systolic velocities were 34 +/- 6 cm/s in the ophthalmic artery, and 14 +/- 3 cm/s in the lateral posterior ciliary arteries. We conclude that blood flow velocities can be measured in defined vessel areas in the orbit.

Four cases of homocystinuria with lens luxation have been examined. As judged from the plasma amino acid pattern, they all responded well on pyridoxine treatment. Two of them discontinued the treatment on their own, and one of these died at the age of 17 years. The lens luxation progressed in one case despite adequate treatment. Scanning electron microscopy of one lens revealed partly broken zonules, abnormal zonular attachment, and a spongy appearance of the capsule proper. Hoping that adequate treatment will reduce more serious complications such as thromboembolism in these patients, it is concluded that an early diagnosis largely depends on the ophthalmologist, who should perform the silver-nitroprusside test, specific for homocystinuria, in all patients with non traumatic lens luxation.

High-performance liquid chromatography on a Supelcosil LC-HN2 analytical column in weak anion exchange mode has allowed separation of ascorbic acid, in less than 5 min, from other interfering substances in serum and aqueous humour. UV monitoring at 254 nm enables ascorbic acid to be detected at 20 pmol level. A method for determination of ascorbic acid concentration in serum and aqueous humour is described, and values from 10 cataract patients are reported.