• An experimental platform for systemic drug delivery to the retina.

      Campbell, Matthew; Nguyen, Anh T H; Kiang, Anna-Sophia; Tam, Lawrence C S; Gobbo, Oliviero L; Kerskens, Christian; Ni Dhubhghaill, Sorcha; Humphries, Marian M; Farrar, G-Jane; Kenna, Paul F; et al. (2009-10-20)
      Degenerative retinopathies, including age-related macular degeneration, diabetic retinopathy, and hereditary retinal disorders--major causes of world blindness--are potentially treatable by using low-molecular weight neuroprotective, antiapoptotic, or antineovascular drugs. These agents are, however, not in current systemic use owing to, among other factors, their inability to passively diffuse across the microvasculature of the retina because of the presence of the inner blood-retina barrier (iBRB). Moreover, preclinical assessment of the efficacies of new formulations in the treatment of such conditions is similarly compromised. We describe here an experimental process for RNAi-mediated, size-selective, transient, and reversible modulation of the iBRB in mice to molecules up to 800 Da by suppression of transcripts encoding claudin-5, a protein component of the tight junctions of the inner retinal vasculature. MRI produced no evidence indicative of brain or retinal edema, and the process resulted in minimal disturbance of global transcriptional patterns analyzed in neuronal tissue. We show that visual function can be improved in IMPDH1(-/-) mice, a model of autosomal recessive retinitis pigmentosa, and that the rate of photoreceptor cell death can be reduced in a model of light-induced retinal degeneration by systemic drug delivery after reversible barrier opening. These findings provide a platform for high-throughput drug screening in models of retinal degeneration, and they ultimately could result in the development of a novel "humanized" approach to therapy for conditions with little or no current forms of treatment.
    • Giant cell tumour in the foot of a skeletally immature girl: a case report.

      Baker, Joseph F; Perera, Anthony; Kiely, Paul D; Lui, Darren F; Stephens, Michael M; Cappagh National Orthopaedic Hospital, Cappagh Road, Finglas, Dublin 11, Ireland. joseph.f.baker@gmail.com (2009-08)
      We present a case of delayed diagnosis of a benign giant cell tumour (GCT) of the third metatarsal in a skeletally immature girl. The patient underwent en bloc excision of the tumour. The tumour had replaced the third metatarsal and had infiltrated the surrounding soft tissue and the second and fourth metatarsal bases. Deep, lateral and medial margins were all involved. A high index of suspicion is needed when evaluating any tumours of the foot, because the compact structure of the foot may delay diagnosis. Early detection is important for avoiding amputation, as the hindfoot and midfoot are classified as one compartment and radical resection is impossible to achieve. Tumours grow faster in the foot than in other bones. GCT in this location and age-group are rare and should be considered in the differential diagnosis of a destructive bony lesion in skeletally immature patients.
    • Lap belt injuries in children.

      McGrath, N; Fitzpatrick, P; Okafor, I; Ryan, S; Hensey, O; Nicholson, A J (2010-07)
      The use of adult seat belts without booster seats in young children may lead to severe abdominal, lumbar or cervical spine and head and neck injuries. We describe four characteristic cases of lap belt injuries presenting to a tertiary children's hospital over the past year in addition to a review of the current literature. These four cases of spinal cord injury, resulting in significant long-term morbidity in the two survivors and death in one child, arose as a result of lap belt injury. These complex injuries are caused by rapid deceleration characteristic of high impact crashes, resulting in sudden flexion of the upper body around the fixed lap belt, and consequent compression of the abdominal viscera between the lap belt and spine. This report highlights the dangers of using lap belts only without shoulder straps. Age-appropriate child restraint in cars will prevent these injuries.
    • Recent onset neck pain with associated neurological deficit--Pott's disease remains an important differential diagnosis.

      Bourke, M G; Coyle, D; Murphy, C G; Madhavan, A; McCabe, J P; Department of Trauma and Orthopaedics, University College Hospital Galway. mikebourkecork@yahoo.co.uk (2010-11-05)
      The incidence of spinal tuberculosis is increasing in developed nations. In Ireland, half of all cases seen in the most recent decade for which figures are available were diagnosed in 2005-2007, the three most recent years for which there is complete data. We discuss a patient who presented with neurological complications due to destructive spinal tuberculous disease affecting the sixth cervical vertebra.
    • Safety in magnetic resonance units: an update.

      Farling, P A; Flynn, P A; Darwent, G; De Wilde, J; Grainger, D; King, S; McBrien, M E; Menon, D K; Ridgway, J P; Sury, M; et al. (2010-07)