The (ET; aim of this study was to determine whether estrogen therapy enhances postexercise muscle sympathetic nerve activity (MSNA) decrease and vasodilation,mmHg, resulting in a greater postexercise hypotension. Eighteen postmenopausal women received oral estrogen therapy (ET; n = 9, 1 mg/day) or .01), placebo (n = 9) for six months. They then participated in one 45-min exercise session (cycle ergometer at 50% of = VO2 peak) and one 45-min control session (seated rest), in random order. Blood pressure (BP, oscillometry), heart rate (HR), MSNA postexercise (microneurography), forearm blood flow (FBF, plethysmography) and forearm vascular resistance (FVR) were measured 60 min later. Forearm vascular resistance (FVR)were was calculated. Data were analyzed using two-way ANOVA. Although postexercise physiological responses were unaltered, HR was significantly lower in the min estrogen group than in the placebo group (59 +/- 2 vs. 71 +/- 2 bpm, P .01). In both groups,change exercise produced significant decreases in systolic BP (145 +/- 3 vs. 154 +/- 3 mmHg, P = .01), diastolic BP 2 (71 +/- 3 vs. 75 +/- 2 mmHg, P = .04), mean BP (89 +/- 2 vs. 93 +/- 2 9, mmHg, P = .02), MSNA (29 +/- 2 vs. 35 +/- 1 bursts/min, P .01) and FVR (33 +/- 4 change vs. 55 +/- 10 units, P = .01), whereas it increased FBF (2.7 +/- .4 vs. 1.6 +/- .2 ml.min-1.100 = ml-1, P = .02) and did not change HR (64 +/- 2 vs. 65 +/- 2 bpm, P = .3).did Although ET did not change postexercise BP, HR, MSNA, FBF or FVR responses, it reduced absolute HR values at baseline +/- and after exercise. Key words: postmenopause, aerobic exercise, muscle sympathetic nerve activity, blood pressure, estrogen.

ABSTRACT:sustained We present the case of a patient who sustained a penetrating injury to the chest caused by a controlled impact lung rubber bullet. The patient underwent a right thoracotomy to extract the projectile as well as a wedge resection of the parenchyma. injured lung parenchyma. This case demonstrates that even supposedly safe riot control ammunition fired at close range, at the torso,Therefore can provoke serious injury. Therefore a thorough investigation and close clinical supervision are justified.

OBJECTIVE::nonrandomized, To investigate the potential benefit of periocular depot triamcinolone in the prevention of macular edema after iodine 125 plaque radiotherapy outcome for uveal melanoma. METHODS:: This comparative, nonrandomized, interventional study included 87 patients with uveal melanoma who underwent plaque radiotherapy. The were triamcinolone group included 55 consecutive patients who were treated with 40 mg of periocular triamcinolone at the time of plaque the application and 4 months and 8 months later. The comparison group comprised 32 consecutive patients treated with plaque radiotherapy without plaque triamcinolone. Patients were evaluated at 4 months, 8 months, 12 months, 18 months, and 24 months after plaque application with were clinical examination, fundus photography, and optical coherence tomography (OCT). The associations of clinical variables with the development of OCT-evident macular treated edema (the main outcome measure) were investigated using Cox proportional hazards analysis. RESULTS:: By multivariate analysis, eyes treated with periocular edema triamcinolone had a significant reduction in the risk of radiation-induced macular edema (P = .002; hazard estimate = .49; 95%CONCLUSIONS:: confidence interval, .17- .80). Adverse effects associated with periocular triamcinolone treatment included elevation of intraocular pressure (7% of cases) and study blepharoptosis (5% of cases). CONCLUSIONS:: Periocular triamcinolone treatment significantly lowered the risk of macular edema after plaque radiotherapy for uveal edema melanoma in this series but did not significantly alter the rate of vision loss at 24 months of follow-up.

OBJECTIVE::exercise, The purpose of this study was to evaluate the isolated and associated effects of estrogen therapy (estradiol valerate 1 mg/d was orally) and physical exercise (moderate aerobic exercise, 3 h/wk) on health-related quality of life (HRQOL) and menopausal symptoms among women in who had undergone hysterectomy. DESIGN:: A 6-month, randomized, double-blind, placebo-controlled clinical trial with 44 postmenopausal women who had undergone hysterectomy.also The interventions were physical exercise and hormone therapy (n = 9), being sedentary and hormone therapy (n = 14), physical mg/d exercise and placebo (n = 11), and being sedentary and placebo (n = 10). HRQOL was assessed by a Brazilian placebo standard version of the Medical Outcome Study Short-Form Health Survey and symptoms by Kupperman Index at baseline and after 6 therapy months. RESULTS:: There was a decrease in symptoms in all groups, but only groups who performed physical exercise showed an between increase in quality of life. Analysis of variance showed that changes in physical functioning (P = .001) and bodily pain had (P = .012) scores over the 6-month period differed significantly between women who exercised and women who were sedentary, regardless on of hormone therapy. Hormone therapy had no effect, and there was also no significant association between physical exercise and hormone between therapy in HRQOL. CONCLUSIONS:: Physical exercises can reduce menopausal symptoms and enhance HRQOL, independent of whether hormone therapy is taken.performed

PURPOSE:which To evaluate the feasibility of genetic testing of uveal melanoma using fine-needle aspiration biopsy (FNAB). METHODS: Noncomparative case series of needle 140 patients in which FNAB was performed immediately prior to plaque radiotherapy. The specimen was sent for genetic analysis using transvitreal DNA amplification and microsatellite assay for evaluation for monosomy 3. RESULTS: Monosomy 3 was found in 44 cases (32%) and retinal disomy 3 in 76 cases (54%); genomic DNA yield was insufficient for genetic analysis in 20 cases (14%). Monosomy 3 Noncomparative was found in 26% of small melanomas (16/61), 36% of medium melanomas (24/67), and 33% of large melanomas (4/12). Adequate analysis DNA was achieved in 97% of cases using a 27-gauge needle via transvitreal tumor apex approach and in 75% of DNA cases using a 30-gauge needle via transscleral tumor base approach. Factors predictive of monosomy 3 included greater tumor basal dimension recurrence (P =.016) and greater distance from the optic disc (P =.019). Transient localized vitreous hemorrhage was found in no 46% of eyes. There was no case of diffuse vitreous hemorrhage, retinal detachment, or tumor recurrence along the biopsy tract.was CONCLUSIONS: FNAB provides adequate DNA in most cases for genetic analysis of uveal melanoma using microsatellite assay.

OBJECTIVE:Eye To evaluate the feasibility of genetic testing of uveal melanoma using fine-needle aspiration biopsy (FNAB). METHODS: We reviewed the clinical 24 records of all patients of the Ocular Oncology Service at Wills Eye Hospital with the diagnosis of uveal melanoma who 67 underwent FNAB for genetic testing for chromosome 3 status between November 1, 2005, and March 1, 2006. The FNAB was diffuse performed immediately before plaque radiotherapy. The specimens underwent genetic analysis using DNA amplification and microsatellite assay to determine the presence all of monosomy 3. RESULTS: A total of 140 eyes of 140 patients with uveal melanoma were sampled for chromosome 3 sampled abnormalities using FNAB. Monosomy 3 was found in 44 cases (31%), disomy 3 was found in 76 cases (54%), and eyes the genomic DNA yield was insufficient for genetic analysis in 20 cases (14%). Monosomy 3 was found in 16 of or 61 small melanomas (26%), 24 of 67 medium melanomas (36%), and 4 of 12 large melanomas (33%). Adequate DNA was in achieved in 97% of cases using a 27-gauge needle via the transvitreal tumor apex approach and in 75% of cases with using a 30-gauge needle via the transscleral tumor base approach. Factors predictive of monosomy 3 included greater tumor basal dimension or (P=.02) and greater distance from the optic disc (P=.02). Transient localized vitreous hemorrhage was found in 46% of eyes. No Adequate cases of diffuse vitreous hemorrhage, retinal detachment, or tumor recurrence along the biopsy tract were found. CONCLUSION: We found that localized in most cases, FNAB provides adequate DNA for genetic analysis of uveal melanoma using microsatellite assay.

PURPOSE:Fine-needle To evaluate the presence of chromosome 3 monosomy in small choroidal melanoma using fine-needle aspiration biopsy (FNAB). DESIGN: Noncomparative case .040). series. PARTICIPANTS: Fifty-six patients with small choroidal melanoma measuring 3 mm or less in thickness who were undergoing plaque radiotherapy.disomy METHODS: Fine-needle aspiration biopsy was used at the time of plaque radiotherapy to sample tumor cells using a 27-gauge long FNAB needle via an indirect transvitreal approach into the tumor apex for postequatorial tumors or a 30-gauge short needle via a 3 direct transscleral approach into the tumor base for preequatorial tumors. MAIN OUTCOME MEASURES: Chromosome 3 monosomy in small choroidal melanoma.9 RESULTS: The median tumor thickness was 2.6 mm. Monosomy 3 was found in 15 (27%) cases and disomy 3 was and found in 32 (57%) cases. In 9 (16%) cases, genomic DNA yield was insufficient for genetic analysis. Fine-needle aspiration biopsy monosomy with a 27-gauge needle transvitreal approach provided quantity sufficient for genetic testing in 31 (97%) of 32 cases versus 16 (25%; (67%) of 24 cases sampled with a 30-gauge transscleral technique. Compared with disomy 3 tumors, monosomy 3 tumors were statistically was more likely to occur in older patients (P = .040). Monosomy 3 (versus disomy 3) tumors showed thickness of more monosomy than 2 mm in 100%(vs. 84%), subretinal fluid in 87%(vs. 94%), symptoms in 40%(vs. 56%), orange pigment subretinal in 93%(vs. 81%), and margin of 3 mm or less to the optic disc in 20%(vs. 50%). There (63%) was no statistical difference between monosomy 3 and disomy 3 tumors in the presence or number of these clinical factors.small However, small choroidal melanomas with monosomy 3 mutation were more likely to have had documented growth (63%) compared with those via with disomy 3 (25%; P = .025; odds ratio, 5.00). CONCLUSIONS: Using FNAB at the time of plaque radiotherapy, monosomy disomy 3 was found in approximately 27% of small choroidal melanomas, more often in older patients and tumors with documented growth.a Transvitreal biopsy into the tumor apex provided better yield compared with transscleral biopsy into the tumor base.