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To evaluate the short-term electrophysiologic effects of intravitreal bevacizumab in the treatment of exudative age-related macular degeneration (AMD).Nine subjects with AMD who received treatment with intravitreal bevacizumab for exudative AMD underwent pretreatment testing with multifocal electroretinography (mf-ERG) or Ganzfeld electroretinography (G-ERG). All five G-ERG subjects underwent repeated testing at 1 week after intravitreal bevacizumab. All four mf-ERG subjects and four of the five G-ERG subjects underwent repeated testing with the same pretreatment protocol at 1 month after treatment. One G-ERG subject also received a second intravitreal injection of bevacizumab at 6 weeks after initial treatment and underwent repeated testing at 1 month after the second dose (3 months after initial treatment).All four subjects undergoing mf-ERG had improvement of the macular response at 1 month of after treatment. The average improvement in response density of the central 15 degrees of macular response was 35% (range, 11-65%). Subjects undergoing G-ERG testing had no significant changes in electrophysiologic response, although some variation in amplitude and implicit time was noted at different testing times. Optical coherence tomography central subfield thickness decreased from 298 microm at baseline to 274 microm at 1 month after treatment. Visual acuity improved in a majority of subjects.In this study, the intravitreal use of bevacizumab resulted in improvement of mf-ERG macular function responses and relatively stable G-ERG responses. The macular electrophysiologic response suggests that macular function improves with treatment. G-ERG suggests that there is no significant measurable photoreceptor toxicity with the use of intravitreal bevacizumab over the short term.

Plasma transthyretin (TTR) is synthesized in the liver and is the source for visceral amyloid deposits in TTR amyloidosis. However, TTR is also synthesized in the retinal pigment epithelium of the eye and choroid plexus of the brain. It has been postulated that vitreous amyloid, which is associated with approximately 20% of the known amyloidogenic TTR mutations, results from local synthesis of TTR in the eye. In order to elucidate if differences in amyloid between organs exists, we have analyzed vitreous and cardiac amyloid fibrils in Ile84Ser TTR patients for comparison. Analysis of guanidine hydrochloride solubilized protein from isolated vitreous and cardiac amyloid fibrils indicated that the amyloid TTR in both organs is highly proteolyzed with minor amounts of intact TTR present. While vitreous protein was amenable to direct Edman sequence analysis, cardiac protein gave low yields indicating it was mostly N-terminally blocked or inaccessible to Edman degradation. While vitreous contained major 11 kDa and minor 9 kDa fragments, cardiac contained at least three major fragments of 7-11 kDa. Vitreous protein was cleaved between Lys48-Thr49, while cardiac protein was cleaved at multiple sites in the residue 46-52 region. While deposits in both tissues were enriched in variant TTR, vitreous fibrils contained more variant protein than cardiac fibrils (80-89% vs. 60-65% Ser84TTR). These differences suggest that the mechanism or pathway of fibril formation may differ in various tissues.

An improved insert earphone for audiometric testing is provided, having a housing, a receiver located within the housing, a flexible eartip located externally to the housing, and a tube nipple acoustically coupled between the receiver and the flexible eartip. The flexible eartip has a flexible tube portion that is coupled to an output end of the tube nipple, which may be rigid. The housing and tube nipple are configured and arranged such that the angle between a longitudinal axis of the tube nipple and the vertical axis is obtuse, minimizing the stress on the ear canal when the flexible eartip is inserted therein. An acoustic damper may be located at or near the input end of the tube nipple to prevent ear wax from clogging the damper and minimize the need for damper replacement.

A single integrated circuit chip is provided with transistors, diodes, resistor and capacitors thereon for forming a variable gainamplifier (40) and gain control circuitry which provides a level dependent frequency response characteristic, operative at low signal levels to enhance gain at higher frequencies relative to that at lower frequencies. The gain control circuitry includes logarithmic rectifier means (48) operative to develop an AC output signal having a peak value varying as a logarithmic function of a signal level which may be that at the output of the variable gain amplifier (40). The AC output signal so developed is applied to a peak detector circuit in a compression ratio control circuit (46) to develop a DC signal which is amplified by a DC amplifier and applied to a control input of the variable gain amplifier (40).

Thirty-six pars plana vitrectomies were performed on 30 eyes of 17 patients with biopsy-proven vitreous amyloidosis. Reopacification of the retrolental vitreous was the most common reason for vitrectomy revision, required in 24% of patients. Complications of amyloid or vitrectomy included retinal detachment requiring scleral buckling in 17% of eyes and glaucoma requiring filtering surgery in 17% of eyes. After a mean 35-month postvitrectomy follow-up, 48% of eyes had visual acuities of 20/40 or better, and 32% of eyes had visual acuities between 20/50 and 20/100. Twenty percent of eyes had visual acuities of 20/200 or worse due either to persistent retinal detachment, open angle glaucoma, or residual opacification of the vitreous.

Eleven emerging alternative treatments for polychlorinated biphenyl (PCB) contaminated sediments have been compared and ranked using technical performance, status of development, test and evaluation data needs, and cost as factors. In ranking the processes, weights were assigned the factors to emphasize the extent of decontamination, the estimated cost of treatment, and the versatility of the process. The emerging treatment processes are based on six different technologies: one on low-temperature oxidation, two on chlorine removal, one on pyrolysis, three on removing and concentrating, one on vitrification, and three on microorganisms. Types of technologies not developed are chlorinolysis, stabilizing, and enzymes. On the basis of the comparisons made, the treatment processes were ranked in the following order from highest to lowest: KPEG, LARC, Acurex, Bio-Clean, Supercritical Water, Advanced Electric Reactor, Vitrification, OHM Extraction, Soilex, Composting, and Dybron Bi-Chem 1006. The first eight processes show potential for reduction of PCB concentrations to the desired background levels (1–5 ppm) or less, with minimum environmental impacts and low to moderate cost. All the technologies except the advanced electric reactor required further development and testing.

Eight emerging alternative treatment processes for Polychlorinated Biphenyl (PCB) contaminated sediments were rated comparatively as to the desirability of their immediate thorough test and evaluation (T and E) based on their scores on five criteria: the probability of cleaning sediments to 2 ppm PCBs or less; the availability of a test system; the test effort required; the time required to provide a commercial size treatment system; and the probable cost of treatment using the process. Two rating methods were applied: a multiplicative model using a Desirability function and a linear model, d-SSYS, using weighted utility functions. The three highest-rated processes were: the Basic Extraction Sludge Treatment (Resources Conservation Company); the UV/Ozone Treatment (Ozonic Technology, Inc.); and the Naturally-Adapted Microbes Process (Bio-Clean, Inc.). Four other processes ranked very close to the top three and merit consideration for testing at least through confirmatory phases: the Galson Potass...

The photooxidation of 2 ppm of propylene and 0.5 ppm of nitrogen oxide was investigated under dynamic flow conditions with sulfur dioxide present in the reaction mixtures at concentrations from 0.0 to 1.2 ppm. The statistical t test showed no significant differences in rates of consumption of propylene and nitrogen oxide or in yields of oxidant, peroxyacetyl nitrate, formaldehyde, and acetaldehyde among tests at the various levels of sulfur dioxide, including 0 ppm. Amounts of sulfur dioxide consumed in the reactions ranged from 25 to 60%. Although a sulfur balance was not obtained, appreciable amounts of sulfate were measured as a product of the oxidation of the sulfur dioxide. On the basis of previous investigations, the sulfate is believed to be present as sulfuric acid aerosol. These results suggest that appreciable levels of oxidant may occur in urban atmospheres even when high concentrations of sulfur dioxide are present. 13 references, 2 tables.

The phacoexcavator permits lens removal via the pars plana by mechanical disruption, hydration, and aspiration within the capsule. The instrument is suitable for use with unimanual, bimanual, or three-port methods. In five cases lenses estimated to have 2+ to 3 + nuclear sclerosis were removed successfully in less than three minutes. There were no postoperative complications and the only intraoperative complication was some loss of cortical material in one case. This was recovered and removed during the vitrectomy.

Response-modifying acoustic couplers are provided for use between an output port of a hearing aid unit and an earmold at the entrance to the ear of a wearer, including a passage and a chamber which respectively provide a high acoustic inertance and a high acoustic compliance to cooperate with other acoustic elements and to form an acoustic network producing a predetermined frequency response characteristic.

A frontalis sling procedure for ptosis repair, employing preserved human bank sclera and polyfilament, cable-type, ophthalmic (Supramid Extra) suture in combination has been devised and tried. Results indicate that these two readily available materials that are now used separately may be combined for lid suspension. They are easy to work with and produce lasting results.