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Jung C.,Max Delbruck Center for Molecular Medicine | Jung C.,Surface Medical
Biochimica et Biophysica Acta - Proteins and Proteomics | Year: 2011

The cytochrome P450 protein-bound porphyrin complex with the iron-coordinated active oxygen atom is called Compound I, which is presumably the intermediate species which hydroxylates inert carbon-hydrogen bonds of substrates. In this mini-review, the milestones in discovering Compound I of cytochrome P450 are summarized. It will be discussed what was known and suggested in the years before 1984, the year when Klaus Ruckpaul's first book about cytochrome P450 appeared, and compared with recent approaches and studies to catch and characterize this intermediate oxygen species in the reaction cycle of cytochrome P450. Although many studies have been undertaken before and after 1984 to characterize Compound I, its electronic structure and physicochemical properties are still a mystery. The conclusion from this review is that the knowledge about Compound I has significantly increased; however, we still ask the same questions. There is a need for improved experimental approaches, detection techniques, and theoretical simulations for future studies of cytochrome P450 Compound I. This mini-review is dedicated to Klaus Ruckpaul on the occasion of his 80th birthday. © 2010 Elsevier B.V. All rights reserved.

A 36-year-old active duty male with migraine headaches presented for evaluation of poorly controlled hypertension. The workup included an endocrinological examination, which revealed a moderately elevated urine normetanephrine level, suggesting the possibility of a pheochromocytoma. The evaluation also included a sleep study for possible obstructive sleep apnea (OSA) because of a history of snoring, apneic episodes, and daytime somnolence. The sleep study confirmed the diagnosis of OSA. The patient was treated with continuous positive airway pressure therapy and a plasma normetanephrine level demonstrated improvement, but persistent elevation. The patient was noted to be taking amitriptyline for migraine headache prevention. With approval from Neurology, the medication was discontinued and a repeat urine normetanephrine level revealed normalization. This case demonstrates the well-documented medication-associated false-positive test result that can be seen in patients taking tricyclic antidepressants. Tricyclic antidepressants, along with phenoxybenzamine, account for 41 to 45% of all elevated metanephrine and normetanephrine levels in patients without pheochromocytoma. This case also shows that patients with OSA can develop hypertension through elevated sympathetic tone, mimicking a pheochromocytoma. Treatment with continuous positive airway pressure therapy is recommended to not only improve hypertension and catecholamine excess but also distinguish the condition from a pheochromocytoma. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Iyer G.,Medical Research Foundation | Iyer G.,Surface Medical | Srinivasan B.,Medical Research Foundation | Agarwal S.,Medical Research Foundation | And 2 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2014

Background: Stevens Johnson Syndrome (SJS) can lead to end stage corneal blindness. This study describes the comprehensive treatment measures and their outcomes in the management of ocular sequelae and complications of SJS. Methods: Four hundred sixty-four eyes of 232 patients of SJS who underwent surgical intervention (punctal cautery, mucus membrane grafting for lid margin keratinisation, fornix reconstructive procedures, tectonic procedures, keratoplasty and keratoprosthesis) were studied. It was a non-comparative, retrospective, interventional case series. The primary outcome was the change in the best corrected visual acuity (BCVA). Secondary outcome measures included an improvement in the ocular surface status as indicated by corneal epithelial fluorescein staining and Schirmer's I strip wetting. Results: The BCVA and the ocular surface status improved and/or stabilized in > 70% of eyes following punctal cautery (n = 160) and > 80% of eyes following lid margin mucus membrane grafting (n = 238). BCVA improved in 50% of eyes following fornix reconstructive procedures (n = 24) with COMET (n = 6), in 63.9% eyes with the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) lens (n = 36), in 81.8% of eyes after cataract surgery (n = 22). A BCVA of ≥20/200 was achieved in 72.34% of eyes following keratoprostheses procedures (n = 47). The mean duration of follow up was 53.3±15.2 months. Conclusion: The ocular sequelae of Stevens Johnson Syndrome can be blinding. They need to be identified and addressed early to retard the continued deterioration of the ocular surface. Our study aims to highlight the problem as well as the importance of comprehensive measures in the management of this potentially blinding disorder. © Springer-Verlag Berlin 2014.

Surface Medical | Date: 2015-09-28

The present disclosure provides for a repair device useful in the repair of surfaces, particularly in a healthcare environment. An exemplary form of the present comprises a repair patch, a pre-mask and release liner; the repair patch interposed between the pre-mask and release liner; the removable adhesive interposed between the pre-mask and repair patch; and the permanent adhesive interposed between the repair patch and the release liner; wherein the adhesion value of the removable adhesive is lower than that of the permanent adhesive.

Choudhari N.,Jadhavbhai Nathamal Singhvi | Neog A.,Jadhavbhai Nathamal Singhvi | Sharma A.,Jadhavbhai Nathamal Singhvi | Iyer G.,Surface Medical | Srinivasan B.,Surface Medical
Indian Journal of Ophthalmology | Year: 2013

Aim: To report our experience with the fibrin sealant as a suture substitute for securing the human scleral patch graft during implantation of Ahmed glaucoma valve (AGV). Materials and Methods: A retrospective, non-comparative study of 12 eyes of 12 patients who underwent an AGV implantation with fibrin sealant for part of the procedure during June 2009 to September 2010. Results: The mean patient age was 21.5 ± 20.6 years. Male: Female ratio was 2 : 1. Seven (58.3%) patients were monocular. The indications for AGV were varied. The mean number of intra-ocular surgeries prior to an implantation of AGV was 1.8. The mean follow-up duration was 24.5 ± 17.9 weeks. There was a statistically significant reduction in the mean IOP and in the mean number of anti-glaucoma medications at the final visit compared to the pre-operative values (P < 0.01, paired t test). Conjunctival retraction was seen in 1 (8.3%) case. The scleral patch graft was retracted posteriorly in another (8.3%) case. There was no case of AGV tube exposure, tube-cornea touch, or conjunctival erosion. Vision threatening complication viz. late post-operative rhegmatogenous retinal detachment, unlikely to be related to the use of the fibrin sealant, occurred in 2 (16.6%) eyes. Conclusion: The fibrin sealant offers the advantages of safety and convenience to the placement of a scleral patch graft during an AGV implantation.

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