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Phosphorylated α-synuclein in the retina is a biomarker of Parkinson's disease pathology severity. These data suggest that phosphorylated α-synuclein accumulates in the retina in parallel with that in the brainincluding in early stages preceding development of clinical signs of parkinsonism or dementia. Thereforethe retina may provide an in vivo indicator of brain pathology severityand its detection could help in the diagnosis and monitoring of disease progression. © 2018 International Parkinson and Movement Disorder Society.PD patients often have visual alterationsfor exampleloss of visual acuitycontrast sensitivity or motion perceptionand diminished electroretinogram responses. The Lewy-type synucleinopathy density in the retina significantly correlated with Lewy-type synucleinopathy density in the brainwith the Unified Parkinson's disease pathology stage and with the motor |
disease. von Hippel-Lindau disease disease increases susceptibility to several malignanciesincluding renal cell carcinomahaemangioblastomas of the central nervous system or retina and phaeochromocytomas. The tumour suppressor generesponsible for the diseaseencodes for a major regulator of the hypoxic response by targeting the transcription factor hypoxia inducible factor for degradation. In this reviewwe present a synopsis of clinical features of the disease and emphasise unique aspects of syndrome in the paediatric population. Genotype-phenotype associations based on the risk of phaeochromocytoma have pointed to the existence of additionalHIF-independent functions of that remain underexplored. We also examine the progress on these pleiotropic roles of VHLwhich contribute to explain clinical features of disease. These advances have important translational implications and are likely to offer a new host of therapeutic options to individuals affected by the disease in the future. |
Cascade of neural processing orchestrates cognitive control in human frontal cortex. Rapid and flexible interpretation of conflicting sensory inputs in the context of current goals is a critical component of cognitive control that is orchestrated by frontal cortex. The relative roles of distinct subregions within frontal cortex are poorly understood. To examine the dynamics underlying cognitive control across frontal regionswe took advantage of the spatiotemporal resolution of intracranial recordings in epilepsy patients while subjects resolved color-word conflict. We observed differential activity preceding the behavioral responses to conflict trials throughout frontal cortex; this activity was correlated with behavioral reaction times. These signals emerged first in anterior cingulate cortex before dorsolateral prefrontal cortex (dlPFC)followed by medial frontal cortex (mFC) and then by orbitofrontal cortex These results disassociate the frontal subregions based on their dynamicsand suggest a temporal hierarchy for cognitive control in human cortex. |
Evaluation of Buccal Infiltration with Articaine and Inferior Alveolar Nerve Block with Lignocaine for Pulp Therapy in Mandibular Primary Molars. Articaine infiltration has the potential to replace inferior alveolar nerve block for primary mandibular molars.Failure of inferior alveolar nerve block in achieving profound anesthesia of the pulp due to various reasons has led to the introduction of more potent local anesthetic agents like articaine. Patients were randomly assigned to receive nerve block with lignocaine or infiltration with articaine on first appointment and the other solution on second appointment. All the pulpotomies and pulpectomies were performed by a pediatric dentist. After the completion of procedurethe patient was asked to record the Facial Image score and Heft-Parker Visual Analogue Score (HP-VAS).Pain Score recorded at the time of injection showed significantly more movements with block as compared to infiltration (p<0.001). scores at time of pulp extirpation were also higher for block than infiltration (p<0.001). |
[Artificial corneal implants (keratoprostheses) (author's transl)]. The history of keratoprosthetics and the pioneer work of Cardona et al. is described and the technical improvements in this method over the past two decades are reviewed. In additionthe results achieved in 17 personal cases are recorded. Visual acuity was definitely improved in 7 casestransient improvement was obtained in 5 cases3 patients retained poor visionand 2 cases showed deterioration. Implantation of artificial keratoprostheses is still at a pioneer stage and further progress can be expected in this field. |
Effect of 5% galactose diet on galactose and dulcitol in plasma and lens of male and female pigs. Plasma galactose and dulcitol levels were measured throughout the diet period and correlated with the lens dulcitol contents at the end of the period. On the first day of the diet there was no significant difference between male and female blood galactose levels after galactose ingestion. The consumption of resulted in a significant 30% decrease in the blood galactose peak in females; there was no parallel difference in males on the diet. The 30-day diet induced a significant decrease in galactosaemia peaks resulting from galactose ingestion in both males and femalesindicating an activation of galactose metabolism. The diet resulted in an equivalent decrease in peak galactosaemia only in malescancelling the initial differences observed between males and females. The final dulcitol content in the lenses appeared to be correlated with plasma galactose but not with plasma dulcitol. Howeverthe differences in plasma galactose between males and femalesor between the two dietsresulted in smaller and often non-significant differences in lens dulcitol. |
Evolving Treatment Patterns and Outcomes of Neovascular Age-Related Macular Degeneration Over a Decade. Management of neovascular age-related macular degeneration (nAMD) has evolved over the last decade with several treatment regimens and medications. Patients with missing data for age or gender and those aged less than 55 years were excluded.Eyes with at least 3 years of follow-up were grouped by years of treatment initiationand 3-year outcomes were compared between the groups. Data were generated during routine clinical care between September 2008 and December 2018.Visual acuity (VA)number of injectionsand number of visits.A total of 15 810 eyes of 13 705 patients receiving 195 104 injections were included. Visual acuity improved from baseline during the first yearbut decreased thereafterresulting in loss of visual gains. This trend remained consistent throughout the past decade. Although an increasing proportion of eyes remained in the driving standardthis was driven by better presenting over the decade. The number of injections decreased substantially between the first and subsequent yearsfrom a mean of 6.25 in year 1 to 3 in year 2 and 2.5 in year 3without improvement over the decade. In a multivariable regression analysisfinal improved by 0.24 letters for each year since 2008and younger age and baseline were significantly associated with at 3 years.Our findings show that despite improvement in functional over the yearsprimarily driven by improving baseline VApatients continue to lose vision after the first year of treatmentwith only marginal change over the past decade. The data suggest these results may be related to suboptimal treatment patternswhich have not improved over the years. Rethinking treatment strategies may be warrantedpossibly on a national level or through the introduction of longer-acting therapies. |
Effects of exercise on sleep symptoms in patients with severe obstructive sleep apnea. To investigate the extent to which exercise is associated with symptoms in patients with severe obstructive sleep apnea (OSA).We included subjects with an apnea-hypopnea index > 30 eventsh who completed validated sleep and exercise questionnaires. We compared symptom frequencyscores between exercisers and nonexercisersadjusting for the usual confounders.The sample included 907 nonexercisers and 488 exercisers (mean age49 ± 14 years; mean ± 20 eventsh; 81% men). Nonexercisers and exercisers differed significantly in terms of obesity (72% vs. 54%)the mean proportion of sleep in non-rapid eye movement stage 3 sleep (9 ± 8% vs. 11 ± 6%)and tiredness (78% vs. 68%). Nonexercisers had a higher symptom frequencyscores and poorer sleep quality. Adjustment for exercise weakened the associations between individual symptoms and the AHIindicating that exercise has a mitigating effect. In binary logistic modelsexercise was associated with approximately 30% lower adjusted questionnaire1 score > 2tiredness; poor-quality sleepunrefreshing sleepand negative mood on awakening. Although the odds of an Epworth Sleepiness Scale score > 10 were lower in exercisersthat association did not withstand adjustment for confounders.Exercise is associated with lower frequencyintensity of symptoms in patients with severe Because up to one third of patients with severe might exercise regularly and therefore be mildly symptomaticit is important not to rule out a diagnosis of in such patients. |
All right reserved. — 3rd ed. p. cm. — (Contemporary neurology series ; 55) Includes bibliographical |
Modified Intrascleral Fixation for Repositioning the Dislocated Single-PieceRigid Intraocular Lens. The modified intrascleral fixation technique shows encouraging midterm results in patients with dislocated single-piecerigid polymethyl methacrylate IOLs. Larger samples and longer follow-up are required to confirm the outcomes of this technique.To describe a modified intrascleral fixation technique for repositioning single-piece rigid polymethyl methacrylate intraocular lenses (IOLs).Four patients with dislocated IOLs were enrolled. Surgical modifications included using ≤1-mm scleral incision for haptic externalizationplacing the haptic placement in scleral tunnelsand using 8-0 absorbable sutures. Patients were followed up for 6 months with routine ophthalmic examinationscorneal endothelial cell countsand ultrasound biomicroscopy (UBM).The mean follow-up time was 13.5 ± 5.45 months. The was well centered and the spherical refraction improved (+10.25 ± 2.21 vs. -0.81 ± 1.59 < 0.05)whereas the best-corrected visual acuity (pre 2043 Snellen0.42 ± 0.33 logarithm of the minimum angle of resolution equivalent and post 2036 Snellen0.31 ± 0.22 logarithm of the minimum angle of resolution equivalent; = 0.235)intraocular pressure (pre 13.8 ± 3.21post 13.55 ± 5.14 mmHg)corneal endothelium density (pre 2,423.8 ± 279.6mmpost 2,280.25 ± 350.7mm)and total astigmatism (pre -1.94 ± 0.43post -1.69 ± 0.59 remained unchanged. The average horizontal and vertical tilt was 0.33 ± 0.22° and 0.81 ± 0.38°respectively. Intraocular lens decentration was 0.10 ± 0.03 mm horizontally and 0.13 ± 0.06 mm vertically. |
Stacked Construct: Novel Substitute for Corneal Tissue Engineering. Corneal traumainjury often results in serious complications including permanent vision loss or loss of visual acuity which demands corneal transplantations or treatment with allogenic graft tissues. There is currently a huge shortage of donor tissue worldwide and the need for human corneal equivalents increases annually. In order to meet such demand the current clinical approach of treating corneal injuries is limited and involves synthetic and allogenic materials which have various shortcomings when it comes to actual transplantations. This new technology brings our in vitro model closer to what is seen in vivo and provides a solid foundation for future studies on corneal biology.Lipids are known for playing a vital role during metabolism and diseased state of various tissues and Sphingolipids are one such class of lipids which are involved in various cellular mechanisms and signaling processes. The impacts of Sphingolipids that have been documented in several human diseases often involve inflammationneovascularizationtumorigenesisand diabetesbut these conditions are not yet thoroughly studied. There is very little information about the exact role of Sphingolipids in the human cornea and future studies aiming at dissecting the mechanisms and pathways involved in order to develop novel therapies. We believe that our novel stacked model can be used to delineate the role of Sphingolipids in the human cornea and provide new insights for understanding and treating various human corneal diseases. |
Evaluation of the 2000 Breger Vision bifocal contact lens. Evaluate the 2000 bifocal contact lens on presbyopic and aphakic patients.Thirty-eight patients37 presbyopes and one aphakewere fit in the and evaluated for 6 months.Twenty patients completed 6 months of contact lens wear. Ten discontinued due to lens related problemsthree discontinued due to other health problemsand five were lost to follow-up. Average refits per eye were 1.75. Average distance visual acuity was 2025; average near visual acuity was average wear time11 hours. Patient satisfaction was rated good in comfort and vision and fair in nighttime glare by patients' subjective evaluation.The 2000 can be a useful addition in fitting the general presbyopic patient population. |
Scleral canal size and optic nerve head drusen. From projected optic disk photographs we measured the size of the scleral canal in two samples of emmetropic patients: one of patients with unilateral pseudopapilledema and drusen and the other of the general normal population. Measurements on the non-drusen-containing optic disk of patients with unilateral drusen were taken to reflect the scleral canal size of the fellowaffected eye. For both trained (t = 6.642) and untrained (t = 4.274) observersthe average diameters of the non-drusen-containing optic disks of patients with unilateral drusen were significantly smaller than those of the optic disks of normal patients = .0005one-tailed independent t-test). The association of a small scleral canal with vascular anomaliesfrequently noted in optic disks of patients with drusenindicates a mesodermal dysgenesis of the optic nerve head. |
The objective was to investigate the usefulness of the "liquid biopsy" of aqueous humor to predict the clinical response after intravitreal injections of anti-VEGF agents for treating diabetic macular edema For this purposeAH samples obtained during the first anti-VEGF from 31 type two diabetic patients were analyzed. Patients were classified into three groups according to their anti-VEGF response: rapid responders (n = 11)slow responders (n = 11)and non-responders (n = 9). In additionpatients (n = 7) who showed good response to corticosteroids but a delayed or no response to anti-VEGF therapy were analyzed. Levels of 17 different cytokineschemokinesand growth factors in were measured using a multiplex immunoassay. We found higher concentrations of in rapid responders to anti-VEGF therapy compared to non-responders. In additionslow responders to anti-VEGF treatment showed higher levels of inflammatory markers than rapid respondersbut did not reach statistical significance. Finallythose patients who responded to corticosteroids but not to anti-VEGF therapy showed significantly lower levels of than patients with rapid response (p = 0.01). In conclusion"liquid biopsy" of could be useful to determine whether the predominant pathogenic event is primarily angiogenic or inflammatory in nature. This approach would allow physicians to select a more rational and cost-effective treatment. Further studies to validate these preliminary results are warranted. |
Congenital cataract screening in maternity wards is effective: evaluation of the Paediatric Cataract Register of Sweden. Eye screening in maternity wards is effective. Response frequency was 96% . Data were derived from the Paediatric Cataract Register (PECARE)Sweden. All Swedish children diagnosed with congenital cataract and operated on before 1 year of age between January 2007 and December 2009 were included. Statistical comparison with earlier retrospective results was performed.Eye screening is a routine protocol at a rate of 90% of Swedish maternity wards. An increase was shown in case referrals from maternity wards compared to 10 years ago (64% vs. 50%). Detection was performed within 6 weeks of age in 75% of the cases. significant difference between the probabilities of early referral (0.38; p < 0.001< 6 weeks of age) and early surgery (0.36; p < 0.001) was found in comparison with the historical data of no maternity-ward screening. Well-baby clinics were instrumental in early detectionas well. |
Aesthetic assessment in periciliary "v-incision" versus conventional external dacryocystorhinostomy in Asians. "V-incision" external has a similar functional success rate to that of the conventional approach and has superior aesthetic outcomes as reported by surgeons and patients. Howevera higher proportion of trainees under supervision performed conventional DCRand it is uncertain whether the outcomes were also influenced by the level of surgeon's expertise.To determine the functional and aesthetic outcomes of periciliary "v-incision" external dacryocystorhinostomy and to compare with conventional approach.Charts review of consecutive cases of "v-incision" or conventional performed in a single institutebetween January 2007 and March 2014. All procedures were performed or supervised by a single surgeon. Two periciliary incisions were made near the skin-mucosal junction at the upper and lower eyelid margins medial to the punctum joining at the medial canthal angle to form a "v" shape. Subcutaneous dissection was carried out inferomedially to reach the anterior lacrimal crest. was then performed in the usual manner. Functional success was defined as no persistent or recurrent epiphora and patency on irrigation of the lacrimal drainage system at least 6 months post-surgery. cross-sectional aesthetic survey was conducted by asking the patients to rate their scar appearance satisfaction on a visual analogue scale External photographs were graded by two independentmasked physicians using as well as the Stony Brook scar evaluation scale (SBSES).Sixty-one patients with median age of 64 years met the inclusion criteriawith median follow-up duration of 28 months. Thirty-eight eyes underwent VDCRand 23 had conventional The functional success rate for was 83.395 % confidence intervals [lower 0.68upper 0.92] and for conventional was 73.9 [lower 0.54upper 0.87]; without statistically significant difference (p = 0.38). patients rated higher aesthetic outcome on (mean scores 95.5 ± 16.8 vs 82.9 ± 25.1p = 0.03). On the SBSESboth observers gave higher aesthetic scores to the group (observer #1 4.6 ± 1.1 and #2 4.7 ± 1.2p < 0.01) than conventional (observer #1 3.1 ± 2.8 and #2 2.8 ± 2.1p < 0.01). More patients reported that they could wear spectacles within 1 week post-VDCR (44.7 vs 4.3 %p < 0.01). |
Some problems after photorefractive keratectomy. We analyzed the data from 1821 patients (2920 eyes) who received photorefractive keratectomy to investigate the postoperative complications which cause a significant decrease in visual acuity. corneal haze of grade 2 or more developed in 9 patients (11 eyes0.38%) and corticosteroid-induced ocular hypertension occurred in 3 patients (4 eyes0.14%). Three patients (4 eyes) who had corneal haze of grade 2 or more underwent repeated photorefractive keratectomy and one patient (2 eyes) with steroid-induced ocular hypertension underwent trabeculectomies. decrease of best spectacle corrected visual acuity of two lines or more was detected in 7 patients (8 eyes0.27%)caused by irregular astigmatismsteroid-induced cataractincidental choroidal neovascular membraneand an unknown origin. Good predictability and stabilization after photorefractive keratectomy was maintained at the 2 year follow-up. Howeversome subjective symptoms were reported by many patients and some complications occurred in a minority of eyes despite the excellent visual outcome in a large majority. |
Glutathione and lens epithelial function. The relationship of the concentration of glutathione in lens epithelium to the transport of cations in the lens was studied by decreasing the level of in the epithelium and monitoring subsequent effects in the lens on the distribution of cationsthe activity of Na+-K+ ATPase and the uptake and efflux of 86Rb. Oxidation of in cultured rabbit lenses was accomplished by the use of 1 mM tertiary butyl hydroperoxide (TBHP)a reagent which appears to be suitable for the specific oxidation of in this tissue. The concentration of found in the normal lens epithelium was estimated to be 64 mum per gram wet weight or nearly six times that present in the whole lens. decrease in the concentration of in lens epithelium of 60 per cent or more leads to an increase in hydrationa shift in the distribution of Na+K+and Cl-a decrease in the activity of Na+-K+ ATPaseand a decrease in the active transportand an increase in the passive diffusion of 86Rb. In the TBHP-treated lenses there is a rapid decrease in the production of lactatepossibly as a result of the inhibition of Na+-K+ ATPasebut the effect on the level of lens is delayed and less pronounced. It appears that the adverse effect on membrane permeability caused by the oxidation of is partially reversed when a high level of returns to the epithelium. Howeverthe decrease in active transport of 86Rb and the inactivation of Na+-K+ ATPase are not reversed by either regeneration of in the tissue or by treatment with exogenous dithiothreitol and may indicate an irreversible conformational change in the enzyme initiated by the loss of the protective effect of The data indicate that a critical level of is required in the lens epithelium for the maintenance of normal cation transport. |
Biomarkers in the pathogenesis of epiretinal membrane and myopic traction maculopathy: Effects of internal limiting membrane incompliance and posterior staphyloma. In the myopic traction maculopathy groupthe spherical equivalent was more myopic and the axial length was longer than in the epiretinal membrane group. Myopic traction maculopathy eyes had larger outer and smaller inner retinal volumeslarger area and perimeter of foveal avascular zonesgreater circularity of foveal avascular zonesand smaller foveal vessel density in the superficial layer than epiretinal membrane eyes. Internal limiting membrane incompliance and staphyloma were significantly more in the myopic traction maculopathy group than in the epiretinal membrane group.The intraretinal changes in myopic traction maculopathy eyes compared with epiretinal membrane eyes showed larger avascular zoneswhich may have been caused by tangential internal limiting membrane incompliance. Anteroposterior traction forces from staphyloma in myopic traction maculopathy eyes may lead to larger outer retinal volumes. In epiretinal membrane eyestraction forces confined to the superficial retina caused large inner retinal volumes and foveal acircularity. |
Expression pattern of Zac1 mouse genea new zinc-finger protein that regulates apoptosis and cellular cycle arrestin both adult brain and along development. Using in situ hybridizationwe analyzed the expression pattern of the Zac1 gene in mouse brain during the embryonic and postnatal development. Zac1 is a new gene that regulates extensive apoptosis and cell cycle arrest through unrelated pathways. At embryonic stagesstrong expression was observed in brain areas with active proliferation (ventricular zone and numerous neuroepithelius) and in nervous system (neural retina and neural tube). In additionsome areas with differentiation activity were noticeably labeled such as arcuate nucleus and amygdaloid region of the brain together with other embryonic sites (hindlimbforelimb and somites). From onwardsthe expression appeared in some proliferative areassuch as subventricular zone and cerebellum (external granular layer and Purkinje cells) and in some synaptic plasticity areassuch as the dorso and ventromedial hypothalamic nucleiarcuate nucleusventral thalamic nucleus. |
Coming into focus: the role of extracellular matrix in vertebrate optic cup morphogenesis. The vertebrate eye acquires its basic form during the process of optic cup morphogenesisduring which the optic vesicle emerges from the brain neuroepithelium andthrough a series of cell and tissue movementstransforms itself into the multilayered optic cupcontaining neural retina (comprised of retinal progenitors)retinal pigmented epitheliumand the lenswhich is derived from the overlying ectoderm. While great strides have been made to understand the developmental signals controlling specificationpatterningand differentiation of the optic cuponly in recent years have the cellular and molecular bases of optic cup morphogenesis begun to be unraveled. One critical component of the morphogenetic process is the extracellular matrix: the complexglycoprotein-rich layer that surrounds the optic vesicle and lens. Though the extracellular matrix has long been visualized by classical histological techniques and postulated to play various roles in optic cup developmentits functional role was uncertain. This is now beginning to changeas live imaging techniquesquantitative image analysesmolecular genetics and in vitro models yield new insights into the process of optic cup morphogenesis and the specific influences of particular extracellular matrix components and their associated signaling pathways. |
An in vitro comparison of the permeability of prednisoloneprednisolone sodium phosphateand prednisolone acetate across the rabbit cornea. Controversy and ambiguity in the literature concerning the corneal penetration of prednisolone acetate over Prednisolone Sodium phosphate in rabbits has recently prompted comparative studies using specific chromatographic assays. In vitrocorneal penetration studies were performed using the Ussing Chambers to compare the permeability and flux of both esters and prednisolone at 0.5% using a reversed phase assay. Chromatograms of samples from the receiver chambers show primarily the presence of prednisolone from both esters; only prednisolone phosphate penetrated the cornea intact. Flux measurements were similar for prednisolone and both salt forms in terms of the metabolite prednisolone. Permeability coefficient calculations give the relative comparison: prednisolone acetate greater than prednisolone greater than prednisolone sodium phosphate. |
Visual detection of Hg2+ with high selectivity using thymine modified gold nanoparticles. Herewe describe a colorimetric sensor for detecting Hg in aqueous mediawhich is simply constructed by the self-assembly of thymine acetamidoethanethiol on gold nanoparticles (AuNPs). Based on the specific interaction of Hg with two thymines (T)the modified AuNPs can be induced to aggregate through the formation of a stable T-Hg-T complex in the presence of Hgresulting in a color change from red to blue-gray. As low as 0.5 µM of Hg can be easily monitored by the naked eye using this sensor. Other metal ionsincluding ZnCdPbNiCuCoMnBaFeCaMgAland Fecould not cause any responseeven at concentrations 100-fold higher than Hg. The high selectivityhigh stability and easy operation enable this sensor suitable for the rapid on-site detection of Hg pollution. |
Elevated advanced glycation end products are associated with subfoveal ellipsoid zone disruption in diabetic macular edema. In DMEincreased levels of AGEs are significantly associated with disruption on SD-OCT.Advanced glycation end products (AGEs)due to increased production and a slow turnover rateserve as mediators of "metabolic memory" even after the resolution of hyperglycemia. The was defined as a hyperreflective band below the external limiting membrane. The disruption of was graded as intact and disrupted Serum AGEs were assessed by assay of Nε-carboxymethyl-lysine (Nε-CML) using the standard protocol. Data were analyzed statistically.Subfoveal disruption was noted in 80% of the cases of In the cases without disruptionvisual acuity (LogMAR was 0.60 ± 0.52whereas in cases with disruptionLogMAR was 0.96 ± 0.56 < 0.001). In the cases without disruptionNε-CML was 94.31 ± 57 ngmLwhereas in cases with disruption Nε-CML was 120.64 ± 71.98 ngmL < 0.001). |
We demonstrate that cyanoacrylate is safe and less resource-demanding without a requirement of second surgery to remove a tamponading agent. It could be helpful in eyes with persistent retinal detachment in colobomatous eyes. Because we were able to achieve favorable outcomes without head positioningwe believe it may also be helpful in patients who are not suitable for positioning because of bodily or bony deformities and in retinal detachment with other coexisting trauma.We report use of cyanoacrylate (N-butyl-Cyanoacrylate) in previously failed retinal reattachment surgeries for chorio-retinal colobomas. We report the surgical techniqueits challengesand long-term outcomes in three patients who underwent the surgery.A chart review of patients with chorio-retinal colobomas and retinal detachment repair with cyanoacrylate at a tertiary eye care center in Nepal. Cyanoacrylate was used to seal colobomatous retinal breaks in eyes which had undergone multiple retinal surgeries with failed outcome.Three eyes that were operated using cyanoacrylate were included. All three patients had attached retina and none of the patients required a long-term tamponading agent. None of the patients underwent head positioning following the surgery. All of the patients had a visual acuity gain of 360 or more at the end of 8 months. No adverse or inflammatory reactions were noted. |
Noise annoyance predicts symptoms of depressionanxiety and sleep disturbance 5 years later. Cross-sectional studies have shown that noise annoyance is strongly associated with mental distresshoweverits long-term effects on mental health is unknown. Noise annoyance was assessed at baseline and 5-year follow-up (sources: road trafficaircraftrailwaysindustrialneighbourhood indoor and outdoor noise; and day vs. nighttime). Depressionanxiety and sleep disturbance were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-2. Participants suffering from depressionanxiety or sleep disturbance at baseline were excluded from the respective multivariate analyses of new onset at follow-up.General noise annoyance remained stable. Daytime noise annoyance predicted new onset of depressiveanxiety symptoms (also nighttime annoyance) and sleep disturbance (beyond respective baseline scores). Additional predictors were female sexlower age and low socioeconomic status Regarding specific sourcesdaytime baseline aircraft annoyance predicted depression and anxiety. Sleep disturbance was most consistently predicted by neighbourhood annoyance (baseline and follow-up) and follow-up annoyance by aircraft (night) and road traffic (day and night).We identified current and past noise annoyances as risk factors for mental distress and sleep disturbance. Furthermorewomenyounger adults and those with lower are particularly susceptible to noise annoyance. Our results indicate the need to provide regulatory measures in affected areas to prevent mental health problems. |
Surface functionalized mesoporous silica nanoparticles for intravitreal application of tacrolimus. Tacrolimus (TAC)a potent immunosuppressive macrolidehas been investigated for ocular diseases due to promising results in the treatment of anterior and posterior segments eye diseases. Mesoporous and functionalized silica nanoparticles show potential as delivery platforms owing to their interesting characteristic as large surface areauniform pore size distributionhigh pore volumeand excellent biocompatibility. The and nanoparticles were characterized. The in vitro cytotoxicity of and load with in retinal pigment epithelial cells was determinedchorioallantoic membrane assay model was used to investigate the in vivo biocompatibilityand safety of intravitreal injection was evaluated using clinical examination (assessment of intraocular pressure and indirect fundus ophthalmoscopy)electroretinographic and histologic studies in rats' eyes. The elemental analysis (CHN)thermogravimetric (TGA)photon correlation spectroscopy and Fourier transform infrared analysis confirmed the presence of functionalized agent and in the nanoparticles. loading was estimated at 7% for the nanoparticles. and did not present in vitro cytotoxicity. The drug delivery systems showed good biocompatibility on Follow-up ERGs showed no changes in the function of the retina cells after 15 days of intravitreal injectionand histopathologic observations support these findings. In conclusionMSNAPTES was successfully synthesizedand physicochemical analyses confirmed the presence of in the nanoparticles. In vitro and in vivo studies indicated that was safe to intravitreal administration. Taking into account the enormous potential of to carry TACthis platform could be a promising strategy for ocular drug delivery in the treatment of eye diseases. |
Plasma-induced graft copolymerization of onto silicone rubber and film improving rabbit corneal epithelial cell attachment and growth. poly(2-hydroxyethyl methacrylate) (pHEMA)-grafted polymer film was prepared by plasma-induced graft copolymerization onto an elastic materialsilicone rubberand a plastic materialpoly(4-methyl-1-pentene) The controlAr plasma-treated and pHEMA-grafted silicone rubber and surfaces were characterized by and contact angle techniques. verified the respective chemical shift of control and Ar plasma-treated films. The presence of the grafted pHEMA was also verified by The introduction of pHEMA onto a hydrophobic support provided an adequate surface for rabbit corneal epithelium cell attachment and growth. Cell attachment and growth onto these surfaces were examined by light microscopy. Cell attachment onto the control and Ar plasma-treated surfaces was negligiblewhile improved attachment and growth of rabbit corneal epithelium cells was demonstrated on the pHEMA-grafted polymeric surface. At 72 hthe pHEMA-grafted silicone rubber surface attached and grew more cells as compared with those on a pHEMA-grafted surface. The pHEMA-grafted silicone rubber surface demonstrated a confluent cell layer after 72 h. |
Retinal nerve fibre and ganglion cell inner plexiform layer analysis by optical coherence tomography in asymptomatic empty sella patients. All the patients and controls competed an automated 30-2 visual field test. The mean deviation (MD)pattern standard deviation (PSD)RNFLand + thickness values obtained with were compared statistically between the two groups.Results: No marked defects were found in either groupand there was no statistically significant between-group difference in or values. In terms of thicknessthe average and superior quadrant values of the patients were thinner than those of the controlswith statistical significance (p = 0.013 and p = 0.043respectively). Although other measured quadrant thicknesses and foveal thickness (FT)macular volume (MV)and average macular thickness values were reduced in the groupthese differences were not statistically significant. The average + value and + values in six sectors in the patient group were significantly lower than those in the control group.Conclusions: Asymptomatic patients have a risk of primary syndrome and should be followed up using a multidisciplinary approach. Objective and quantitative and + thickness measurements obtained with can provide valuable data for monitoring these patients. |
Microkeratome complications of laser in situ keratomileusis. To evaluate the incidencetypesand outcome of microkeratome complications that occur during laser in situ keratomileusis (LASIK).Retrospectivenoncomparativecase series.Three thousand nine hundred ninety-eight eyes that underwent primary by four surgeons between November 1996 and August 1998 at a university-based refractive center.All cases with significant microkeratome complications leading to abandonment of the procedure were identified and reviewed.Incidence of complicationschange in best corrected visual acuity (BCVA)change in refractive errorand types of complication.There were 27 complications leading to abandonment of the procedure of 3998 eyes. The overall rate of microkeratome complication was 1 in 150 but it was 1 in 77 in the surgeons' first 1000 eyesdecreasing to 1 in 250 in the last 1000 eyes. Of the 24 planned bilateral cases15 complications happened on the first operated eye. Twenty-six of 27 eyes recovered to within one line of preoperative BCVAand one eye lost two lines. At last examination before any repeat refractive proceduresspherical equivalent manifest refraction returned to within 1 diopter of its preoperative value in 18 of 19 eyes and astigmatism in 16 of 19 eyes returned to within 1 of its preoperative value. Sixteen of 27 eyes had repeat Two eyes had complications at repeat LASIKone of which led to abandonment of the procedure for a second time.There is a significant learning curve in the use of the microkeratome. If ablation is not performedflap complications rarely lead to significant visual loss and generally do not result in a change in refractive error. |
Factors Affecting the Outcome of Scleral Buckling Surgery for Primary Rhegmatogenous Retinal Detachment. Scleral buckle surgery is a highly effective surgery in uncomplicated retinal detachment casesand single surgery success rates are better in cases with good preoperative visual acuitypartial detachmentand clear crystalline lens.Scleral buckle surgery retains a special place in treatment of retinal detachment despite development of new and advanced vitreoretinal surgical techniques. The outcome of any retinal detachment surgery depends on correct selection of patienttype and nature of detachmentand the expertise. Preoperative and postoperative characteristics were recorded. Parameters that were evaluated to determine the outcome were best-corrected visual acuity (BCVA)anatomical successand complications.A total of 51 eyes of 50 patients that met the inclusion criteria were included. Mean age was 41 ± 19.9 years (range: 9 to 83). Primary anatomical success was achieved in 80.4%. Parameters significantly associated with the anatomical outcome of surgery were status of lenspreoperative visual acuityand extent of retinal detachment. There was a significant improvement of visual acuity postoperatively. |
Differential projections from the vestibular nuclei to the flocculus and uvula-nodulus in pigeons (Columba livia). The pigeon vestibulocerebellum is divided into two regions based on the responses of Purkinje cells to optic flow stimuli: the uvula-nodulus responds best to self-translationand the flocculus responds best to self-rotation. We used retrograde tracing to determine whether the flocculus and uvula-nodulus receive differential mossy fiber input from the vestibular and cerebellar nuclei. From retrograde injections into the both the flocculus and uvula-nodulusnumerous cells were found in the superior vestibular nucleus (VeS)the cerebellovestibular process (pcv)the descending vestibular nucleus (VeD)and the medial vestibular nucleus (VeM). Less labeling was found in the prepositus hypoglossithe cerebellar nucleithe dorsolateral vestibular nucleusand the lateral vestibular nucleuspars ventralis. In the VeSthe differential input to the flocculus and uvula-nodulus was distinct: cells were localized to the medial and lateral regionsrespectively. The same pattern was observed in the VeDalthough there was considerable overlap. In the VeMthe majority of cells labeled from the flocculus were in rostral margins on the ipsilateral sidewhereas labeling from uvula-nodulus injections was distributed bilaterally throughout the VeM. Finallyfrom injections in the flocculus but not the uvula-nodulusmoderate labeling was observed in a paramedian areaadjacent to the medial longitudinal fasciculus. In summarythere were clear differences with respect to the projections from the vestibular nuclei to functionally distinct parts of the vestibulocerebellum. Generally speakingthe mossy fibers to the flocculus and uvula-nodulus arise from regions of the vestibular nuclei that receive input from the semicircular canals and otolith organsrespectively. |
Donation after cardiac death: lessons learned. Despite the increasingly positive outcome of organ transplantation as an accepted treatment of end-stage organ diseasesan average of 15 people die each day awaiting organ transplantation. According to the United Network for Organ Sharingthere are more than 90,000 people in the United States waiting for an organ transplant. In the United Statesless than 1% of all deaths are attributed to brain death. single brain-dead organ donor has the potential to save up to 8 individuals by donating organs and providing up to 50 people with tissue and cornea transplants. The reality is that the source of available brain-dead donors does not meet the needs of the growing waiting list. To help deal with the increasing demand for organsdonation after cardiac death has been reintroduced to families of patients with catastrophic brain injuries. Families have the right to be informed of all potential end-of-life optionsincluding that of organ donation and the use of donation after cardiac death when appropriate. Hospitals and healthcare workers must be committed to provide the option of donation after cardiac death for both donor families and transplant recipients. The purpose of this article is to examine the process of implementing a donation after cardiac death policy in a 1,061-bed tertiary care hospital with level trauma designation. |
Unusual maculopathy secondary to hypergammaglobulinemia in a patient with systemic lupus erythematosus. Patients with atypical macular detachment may be afflicted with a serum immunogammopathy such as multiple myelomaWaldenström's macroglobulinemiaand benign polyclonal gammopathy. Systemic lupus erythematosus should also be ruled out.To report the unusual findings of fluorescein angiography and optical coherence tomography in a case of systemic lupus erythematosus with hypergammaglobulinemia.Interventional case report.A 59-year-old woman had systemic lupus erythematosus but had stopped taking medication for 6 months. Blurred vision was notedand the fundoscopic findings revealed serous macular detachment. Results of optical coherence tomography demonstrated intraretinal and subretinal fluidbut fluorescein angiography showed no leakage. Her best-corrected visual acuity improved after posterior sub-Tenon triamcinolone injection. |
Plasmacytoma associated with canaliculitis. Plasmacytomas are plasma cell neoplasms that rarely involve ocular adnexal tissues as a primary lesion or secondary manifestation of plasma cell myeloma. Only one case of plasmacytoma involving the lacrimal drainage systemto our knowledgeis described in the literature. The clinical presentation of ocular adnexal primary plasmacytoma typically relates to its mass effect. In this clinicopathologic reportwe describe an unusual presentation of primary plasmacytoma of the lacrimal canaliculus as infectious canaliculitis. |
Crystalline lens gradient refractive index distribution in the guinea pig. The crystalline lens undergoes morphological and functional changes with age and may also play a role in eye emmetropisation. Both the geometry and the gradient index of refraction distribution contribute to the lens optical properties. Treated eyes were myopic (-2.07 on average) and untreated eyes hyperopic (+3.3 D)as revealed using streak retinoscopy in the live and cyclopeged animals. custom spectral domain optical coherence tomography system (λ = 840 nmΔλ = 50 nm) was used to image the enucleated crystalline lens at two orientations. Custom algorithms were used to estimate the lens shape and was modelled with four variables that were reconstructed using the data and a minimisation algorithm. Ray tracing was used to calculate the optical power and spherical aberration assuming a homogeneous refractive index or the estimated GRIN.Guinea pig lenses exhibited nearly parabolic profiles. When comparing the two age groups (18- and 39 day-old) there was a significant increase in the central thickness (from 3.61 to 3.74 mm)and in the refractive index of the surface (from 1.362 to 1.366) and the nucleus (from 1.443 to 1.454). The presence of shifted the spherical aberration (-4.1 µm on average) of the lens towards negative values.The guinea pig lens exhibits a profile with surface and nucleus refractive indices that increase slightly during the first days of life. |
Cyclic nucleotide-gated channels in non-sensory organs. Cyclic nucleotide-gated channels represent a class of ion channels activated directly by the binding of either cyclic-GMP or cyclic-AMP. They carry both mono and divalent cationsbut select calcium over sodium. In the majority of the cases studiedbinding of cyclic nucleotides to the channel results in the opening of the channel and the influx of calcium. As a consequencecytosolic free calcium levels increase leading to the modifications of calcium-dependent processes. This represents and important link in the chain of events leading to the physiological response. Cyclic nucleotide-gated channels were discovered in sensory cell typesin the retinaand in olfactory cellsand were extensively studied in those cells. Howeverit is becoming increasingly evident that such channels are present not only in sensory systemsbut in mostif not allcell types where cyclic nucleotides play a role in signal transduction. hypothesis is presented here which attributes physiological importance to these channels in non-sensory organs. Four examples of such channels in non-sensory cells are discussed in detail: those in the liverin the heartin the brainand in the testis with the emphasis on the possible physiological roles that these channels might have in these organs. |
Two major tachykininssubstance and substance Kare localized to distinct subsets of amacrine cells in the anuran retina. Tachykinins are known to be major excitatory neuromodulators in neural systemsincluding the retina of many vertebrate species. Among them substance has been detected in several speciesincluding anurans. Howevernone of the other major tachykinins has been sought for in the anuran retina. Our results show that both substance and substance are localized to wide-field amacrine cells in the retina of a terrestrial frog (Pelobates fuscus). Preabsorption and double-label studies provided evidence that the populations of substance and substance K-immunoreactive cells are clearly distinct and their dendritic arbor do not overlap in the inner plexiform layer of the retina. These findings provide evidence for the presence of (i) a novel anatomicallyneurochemically identifiable amacrine cell type and (ii) predict distinct synthetic pathways for substance and substance in the anuran retina. |
repairrecombination protein promotes the progression of lung adenocarcinoma by activating mTORC1 pathway. Lung adenocarcinoma is the most prevalent form of lung cancer and has a poor prognosis. is a repair protein upregulated in several cancer typesbut its role in progression remains unclear. The Cancer Genome Atlas dataset was analysed to compare the mRNA expression in tumours to that in normal lung tissue. and mRNA expression was confirmed in human cancer cell lines using RT-qPCR. Bioinformatics tools were used to predict the target genes and downstream signalling pathways of Proteins related to RAD54Lapoptosismigrationand the mTORC1 pathway were assessed by Western blotting. Using the datasetwe found that was higher in tumours compared to that in non-cancerous lung tissueand levels were significantly correlated with pathological stage and unfavourable prognosis in patients with was ubiquitously upregulated in cells and FurthermoreRAD54L silencing decreased cell proliferationinvasionand migrationand induced cell apoptosis and cell cycle phase arrest in and human lung cancer cell lines. was predicted as a target gene of overexpression restored malignant cell behaviour in si-RAD54L-treated cells. Bioinformatic analysis suggested that the mTORC1 signalling pathway is downstream of Rapamycin treatment impaired RAD54L-mediated malignant cell behaviour in cells. AdditionallyRAD54L promoted the progression of xenograft tumours and metastasis in vivo. In conclusionthe axis promotes the progression of through the mTORC1 signalling pathway. |
Endoscopic removal of nasoglabellar dermoid cysts. Dermoid cysts are common tumors resulting from entrapped ectodermal elements at fetal suture lines. Management is conceptually straightforwardwith surgical excision of the mass in its entirety without rupture. The conspicuous location and potential scarring from direct excision can be objectionableparticularly in children. The authors describe 2 cases using a hidden hairline incision and an endoscopic approach to remove dermoid cysts in the nasoglabellar region. |
Current molecular methods in epidemiological typing of Acinetobacter baumannii. The emergence of Acinetobacter baumannii during recent decades as an important nosocomial pathogen responsible of worldwideintensively documentedoutbreaks has resulted in a need for effective epidemiological typing methods. Throughout the yearsmany typing methods for baumannii epidemiological studies have been proposed from phenotypic to molecular methods. Currentlythe use of phenotypic typing methods have declined considerably and been progressively replaced by molecular methods. In this reviewwe introduce the current molecular methods available for baumannii typing. Each method has its own advantages and disadvantagesand the selection of an appropriate genotyping method depends on studied objectives. This review sheds light on questions in different epidemiological settings and most molecular methods used to fit these objectives. |
Use of 0.5% apraclonidine solution in evaluation of blepharoptosis. Of these37 eyelids had acquired ptosis and 8 had congenital ptosis. Palpebral fissure height and margin-reflex distance in the upper eyelid were measured before and after instillation of 0.5% apraclonidine2.5% phenylephrineand both drugs.After instillation of 2.5% phenylephrine0.5% apraclonidineand both drugsthe mean increases in palpebral fissure height were 2.12 mm+-1.4 mm2.11 mm+-1.4 mmand 2.26 mm+-1.3 mmrespectivelyand the mean increases in margin-reflex distance were 1.93 mm+-1.2 mm1.89 mm+-1.3 mmand 2.03 mm+-1.2 mmrespectively (p=0.86 and p=0.85). The apraclonidine solution did not alter the test results in 14 eyelids in which the phenylephrine test results were negative.Topical 0.5% apraclonidine solution can be as effective as topical 2.5% phenylephrine in elevating a ptotic upper eyelidand may be used for preoperative evaluation of blepharoptosis. Combined use of both drugs may not provide any additional benefit. |
[Selected cases of eyelid and orbit abnormalities and possibilities for correction]. The article presents abnormalities of the eyelidsthe orbita and the periorbital areas. One part of these conditions disrupts visionthe main function of the eye. The other reasons why they require correction are the aesthetic value of this distinctly visible area of the body and the necessity of improvement. The conditions and the management considerations for these disorders proposed by the author are the followings: ptosis palpebraeanophthalmushyptophthalmus (ablepharon)and tumors. |
Ten-year outcomes in newly diagnosed glaucoma patients: mortality and visual function. Approximately two thirds of patients will still be under care 10 years after presentation. In olderwhite patients with glaucoma the overall goal of preventing visual handicap is achievable for most patients 10 years after diagnosis.To determine the mortality within ten years of diagnosis of chronic open angle glaucoma and the visual field progression amongst survivors of a group of patients who were followed for 10 years.Of the 436 patients seen in a glaucoma case-finding clinic between July 1994 and December 1995 a diagnosis of chronic open angle glaucoma was made in 65. Ten years after diagnosis the outcome of the 57 patients who were treated at the Oxford Eye Hospital was determined. The causes of death were obtained from the general practitioner records and from the official death certificates. The probability of death was analysed using a Kaplan-Meier survival curve. The visual field of each eye of survivors was graded using a nine-stage severity scale. The visual outcome was analysed at the 10-year follow up visit.Seventeen patients died during the 10-year periodincluding nine from cardiovascular disease. The mean age at presentation of those that died was 76.4 years compared with 69.5 years for survivors (p = 0.029). Using a nine-stage grading system42 eyes did not deteriorate30 eyes deteriorated by one stageseven eyes two stages and one eye three stages over the 10-year period. The average time to first deterioration by one stage was 8.51 years 7.92 to 9.10). The mean intraocular pressure was 25.6 mmHg (5.8 mmHg) on presentation and 15.7 mmHg (3.0 mmHg) at the end of 10 years. |
[Ion-sensitive nanoemulsion-in situ gel system for ophthalmic delivery of flurbiprofen axetil]. Production of nanoemulsion was based on high-speed shear and homogenization processand then mixed with gellan gum to prepare images suggested no significant changes in particle morphology of the pre and post gelation. Good ocular compatibility of was testified by the irritation test based on histological examination. In vivo fluorescence imaging system was applied to investigate the characteristics of cornea retentionand the results indicated that the nanoemulsion-in situ gel prolonged the cornea retention time significantly since (0.008 5 min was much lower compared with flurbiprofen sodium eye drops (FB-Na0.03% wv) of which the K(Eye drops) was 0.105 2 minindicated that the cornea retention time of was prolonged significantly. Pharmacokinetics of in rabbit aqueous humor was studied by cornea puncturethe (12.3 h) and AUC(0-12h) (126.8 microg x min x mL of was 2.7 and 2.9 times higher than that of the flurbiprofen sodium eye drops respectivelywhich meant that the ocular bioavailability was improved greatly by the novel preparation. ThereforeFBANE-ISG can enhance the ocular bioavailability by prolonging drug corneal retention significantly. What's moreencapsulated by emulsion droplets prodrug flurbiprofen instead of flurbiprofen can reduce the ocular irritation. |
The anti-excitotoxic effects of certain anestheticsanalgesics and sedative-hypnotics. Various agents were tested for their ability to antagonize the acute excitotoxic action of N-methyl-DL-aspartate and kainic acid on neurons in the in vitro chick embryo retina. The following compounds (in order of descending potencies) were effective in completely blocking the neurotoxic activity of phencyclidineketamine-SKF 10,047pentazocineD-aminophosphonovalerateD-amino-phosphonoheptanoateD-alpha-aminoadipateOH-quinoxaline carboxylatekynurenate-cis-2,3-piperidine dicarboxylatesecobarbitalamobarbital and pentobarbital. The latter 6 agents also protected against toxicity but complete protection was observed only from relatively high concentrations. At 20 mMMg2+ blocked toxicity but at concentrations up to 30 mM did not block toxicity. Compounds that failed to block either or toxicity include and L-aminophosphonobutyrateL-glutamic acid diethyl esterxanthurenateGABA and taurine. The chick embryo retina is a useful preparation for identifying agents that have either excitotoxic or anti-excitotoxic activity. |
The physiological impact of microRNA gene regulation in the retina. microRNAs (miRNAs) are smallstable molecules that post-transcriptionally regulate gene expression in plants and animals by base pairing to partially complementary sequences on target mRNAs to inhibit protein synthesis. More than 250 miRNAs are reportedly expressed in the retinaand miRNA gene regulation has been shown to affect retinal developmentfunctionand disease. Here we highlight recent advances in understanding the functional roles of vertebrate retinal miRNAs. |
To investigate the effect of flap thickness on wavefront aberrations induced by was performed on 56 eyes of 28 patients with refraction errors that were well matched between the right and left eyes. For each patienta planned 160-microm flap was created for one randomly selected eye using the Moria microkeratome (130-microm head; thick flap group)and a 110-microm flap was created for the contralateral eye with the same microkeratome (90-microm head; thin flap group). Flap thickness was measured using ultrasonic pachymetry. Wavefront aberrations were measured in the anterior cornea using the Orbscan (Bausch Lomb) and in the whole eye using the Wavefront Supported Custom Ablation aberrometer (Carl Zeiss Meditec) preoperatively and at 1 month and 1 year postoperatively.Mean flap thickness was 155 +- 13 microm in the thick flap group and 112 +- 11 microm in the thin flap group. Mean root-mean-square of higher order wavefront aberrations were changed for the different test times in the cornea = < .0001) and the whole eye = < .0001). There was no significant difference between the two flap groups for the cornea = 0.76) or for the whole eye = 0.07). Similar results were observed for higher order Zernike aberrations such as spherical aberration and comas.The results suggest higher order wavefront aberrations induced by are independent of flap thickness. Complications in visual outcome for patients with different flap thickness should be attributed to factors other than aberrations. |
Identification of the retinoschisin-binding site on the retinal NaK-ATPase. X-linked juvenile retinoschisis is a hereditary retinal dystrophycaused by mutations in the gene which encodes the secreted protein retinoschisin. In recent yearsseveral molecules have been proposed to interact with retinoschisinincluding the retinal NaK-ATPaseL-voltage gated Ca2+ channelsand specific sugars. We recently showed that the retinal NaK-ATPase consisting of subunits and is essential for anchoring retinoschisin to plasma membranes and identified the glycosylated subunit as the direct interaction partner for retinoschisin. We now aimed to precisely map the retinoschisin binding domain(s) in In generalretinoschisin binding was not affected after selective elimination of individual glycosylation sites via site-directed mutagenesis as well as after full enzymatic deglycosylation of Applying the interface prediction tool PresConttwo putative protein-protein interaction patches ("patch and "patch consisting each of four hydrophobic amino acid stretches on the surface were identified. These were consecutively altered by site-directed mutagenesis. Functional assays with the patch mutants identified patch andspecificallythe associated amino acid at position 240 (harboring a threonine in as crucial for retinoschisin binding to These and previous results led us to suggest an induced-fit binding mechanism for the interaction between retinoschisin and the NaK-ATPasewhich is dependent on threonine 240 in allowing the accommodation of hyperflexible retinoschisin spikes by the associated protein-protein interaction patch on |
Radiology reading-caused fatigue and measurement of eye strain with critical flicker fusion frequency. declines after reading and can be considered useful as an indicator of fatigue induced by radiology reading. questionnaire was also completed on duration of sleep the night before the experimentaverage duration of sleepand subjective fatigue using a visual analog scale (corrected to a 0-1 scale0 indicating the worst fatigue ever experienced).After-reading subjective fatigue was significantly greater (before 0.52 ± 0.15after 0.42 ± 0.15)and was significantly lower (before 40.9 ± 2.4after 39.9 ± 2.0). There was no significant correlation between subjective fatigue and CFFFeither before or after or between before- and after-reading differences in subjective fatigue and Shorter duration of sleep the night before significantly correlated with lower (Pearson's correlation coefficient): before = 0.0047; after = 0.0003. |
Laser treatment to large iris cyst secondary to trabeculectomy. We report a case of postoperative large iris cyst secondary to trabeculectomy treated with Nd:YAG laser iridocystotomy. The patient was subsequently free of discomfort or significant inflammation.This case suggests that large iris cysts may produce corneal decompensation. Laser treatment can collapse the iris cyst without other ocular tissue damage. |
Phosphorylated neurofilament heavy chain is a marker of neurodegeneration in Leber hereditary optic neuropathy To determine the profile of neurodegeneration in Leber hereditary optic neuropathy (LHON).We quantitated serum levels of phosphorylated neurofilament heavy chain (pNF-H) in a Brazilian pedigree of 16 affected patients and 59 carriers with LHONboth molecularly characterized as harboring the to mutation at nucleotide 11,778 of the mitochondrial genome. The association of subject characteristics to pNF-H levels was studied with multiple regression; pNF-H data were square-root transformed to effect normality of distribution of residuals. Relationships between the square-root of pNF-H and age and sex were investigated within groups with Pearson correlation and the two-sample t-test. Linear regression was used to assess the difference between groups and to determine if the relationship of age was different between affected individuals and carriers. Results of plotting pNF-H levels by age suggested a nonlinearquadratic association so age squared was used in the statistical analysis. was used to assess the influence of age and group on pNF-H levels.In the carrier groupthere was a significant correlation of square-root pNF-H (mean=0.24 ngml with age (r=0.30p=0.022) and a stronger correlation with quadratic age (r=0.37p=0.003). With a higher mean pNF-H (0.33 ngml for the affected groupcorrelations were of similar magnitudealthough they were not statistically significant: age (r=0.22p=0.42)quadratic age (r=0.22p=0.45). There was no correlation between age and pNF-H levels (mean=0.34 ngml in the off-pedigree group: age (r=0.03p=0.87)quadratic age (r=0.04p=0.84). There was no difference between sexes and pNF-H levels in any of the groups (affectedp=0.65; carriersp=0.19; off-pedigreep=0.93).Elevated pNF-H released into the serum of some affected patients may suggest that axonal degeneration occurs at some point after loss of visual function. Increases in pNF-H levels of carriers with increasing agenot seen in off-pedigree controlsmay suggest subtle subclinical optic nerve degeneration. |
The pattern and distribution of malignant neoplasms among Yemeni patients. Gastrointestinal tract in general with breast in femaleswere the most frequent sites of malignancies in the Republic of Yemen. All specimens were diagnosed by one pathologist based on the International Classification of Disease for Oncology.Results revealed comparable male: female ratio and mean age of 46.1 +- 22.8 in males and 44.2 +-18.3. The most common cancers were the gastrointestinal tract malignancies22%. Lymph node cancers constituted 16%followed by head and neck malignant tumors 12%skin 10%urinary tract 8%bone and soft tissue 8%breast 8%female genital system 5%thyroid gland 2% and finally male genital systembone marrow and central nervous systemeye 2% each. For female patients breast cancers and gastrointestinal tract cancers were equally the most frequent malignancies. Skin cancersfollowed by gastrointestinal tract and male genital system affected mostly older age patients. While bone marrow followed by central nervous system and eyethen bone and soft tissue cancers were mostly diagnosed in young age patients. Within the gastrointestinal tract liver was the most affected site 33% and adenocarcinomas were the most frequent diagnosed type 42%. Among lymph nodes malignancies non-Hodgkin's lymphoma constituted 42%. Oral cavity cancers constituted 73% of head and neck malignancieswhere squamous cell carcinoma constituted 65%. |
Evidence for asialo as a corneal glycolipid receptor for Pseudomonas aeruginosa adhesion. Anti-gangliotetraosylceramide (anti-asialo and antiparagloboside monoclonal antibodies (MAbs) were used in immunofluorescenceimmunoelectron-microscopicand in vitro binding inhibition assays to determine whether either of the glycolipids was detectable in the normal corneawhether levels changed following corneal scarification and either trypsin treatment or incubation in vitro with Pseudomonas aeruginosaand whether either of the MAbs could competitively inhibit aeruginosa binding to cornea. No immunostaining above background for either glycolipid was observed in frozenunfixed sections or in lightly fixedK4M-embedded antibody-gold-labeled thin sections of normal cornea. In frozen sections of organ-cultured scarified corneano increased immunostaining for anti-asialo or antiparagloboside reactivity was noted immediately or 60 min after corneal scarification. Howeverat 60 min after scarification and in vitro incubation of the eye with either trypsin or aeruginosaenhanced immunostaining for both glycolipids was associated with cells within or immediately adjacent to the wound site. Trypsin increased immunoreactivity in the wound site more markedly compared with incubation with aeruginosabut immunostaining was similarly localized with either treatment. No staining above background was seen in control sections. Similarlywith immunoelectron microscopyincreased immunogold-MAb staining for both glycolipids was seen on the plasma membranes of the wound-site cells of eyes incubated with either trypsin or aeruginosa compared with controls that were similarly immunostained but with the primary antibody either omitted or substituted with a nonspecific MAb. Competitive binding inhibition assaysin which the bacterial inoculum or the eye in organ culture was incubated with anti-asialo MAb prior to topical ocular application of the bacteriashowed significantly decreased aeruginosa adhesion compared with preparations similarly treated with phosphate-buffered saline or antiparagloboside MAb. These data provide evidence to support the hypothesis that asialo GM1not paraglobosideserves as a receptor for aeruginosa binding to the scarified cornea of the adult mouse and spatially localizes both glycolipids in the wound site. |
Trapped Pre-Macular Bubble of Octafluoropropane Gas Masquerading as Retained Submacular Perfluorocarbon Liquid. Submacular entrapment of various substances used during vitrectomy has been described in a number of case reports and case series. To our knowledgethis is the first described case of a retained fragment of fluorocarbon gas trapped at the macula following successful retinal detachment repair and highlights a previously unreported cause of an abnormal foveal appearance. Howeverclinical examination together with the use of is helpful in differentiating the appearance from that seen in other retained vitrectomy adjuncts.To demonstratewith the aid of retinal imagingan abnormal post-operative macular appearance caused by the presence of a "fragmented" pre-retinal bubble of octafluoropropane masquerading as retained subretinal perfluorocarbon liquid (PFCL).This is an interventional case presentation.Colour fundus photography high-resolution spectral domain-optical coherence tomography and clinical progress demonstrate that the abnormal reflex was caused by the presence of a small fragment of becoming lodged at the pre-foveal area. |
Head-down posture induces alterations in early glaucoma. To probe susceptibility of retinal ganglion cells to physiological stressors associated with moderate head-down body tilt in patients with suspicion of glaucoma or early manifest glaucoma (EMG).One hundred nine subjects with best corrected visual acuity ≥ 2020 and no disease other than glaucoma [glaucoma suspects (GS)=79EMG=14normal controls and comparable age range were tested. Noncontact intraocular pressure (IOP)pattern electroretinogram (PERG)and brachial blood pressureheart rate measurements were performed in 3 consecutive conditions (∼0038 min apart): seated (baseline)-10-degree whole body head-down tilt (HDT)and seated again (recovery). amplitude and latencyIOPand systolicdiastolic blood pressuresheart ratecalculated mean central retinal artery pressureocular perfusion pressureand systolicdiastolic perfusion pressures were evaluated.During significantly increased in all groups approximately to the same extent (approximately 20%). amplitude did not change in but decreased significantly in patients -23%). phase become delayed in but more so in patients The proportion of patients with alterations significantly exceeding those occurring in age-adjusted and baseline-adjusted wereGS: amplitude 20%phase 15%; amplitude 14%phase 50%. All measures recovered baseline values after HDT.Moderate induces temporary worsening of function in a subpopulation of and patients. This noninvasive protocol may help disclose abnormal susceptibility of RGCs in a subset of the patients at risk of glaucoma. |
Evaluating the role of retinal membrane guanylyl cyclase 1 (RetGC1) domains in binding guanylyl cyclase-activating proteins (GCAPs). Retinal membrane guanylyl cyclase 1 (RetGC1) regulated by guanylyl cyclase-activating proteins (GCAPs) controls photoreceptor recovery and when mutated causes blinding disorders. We evaluated the principal models of how and bind RetGC1: through a shared docking interface versus independent binding sites formed by distant portions of the cyclase intracellular domain. At near-saturating concentrationsGCAP1 and activated RetGC1 from cells and RetGC2GCAPs1,2 mouse retinas in a non-additive fashion. The GCAP1which binds but does not activate RetGC1suppressed activation of recombinant and native RetGC1 by competing with both and Untagged displaced both and from the complex with RetGC1 in cells. The intracellular segment of a natriuretic peptide receptor guanylyl cyclase failed to bind GCAPsbut replacing its kinase homology and dimerization domains with those from RetGC1 restored and binding by the hybrid cyclase and its GCAP-dependent regulation. Deletion of the Tyr-Ser fragment in RetGC1 did not block binding to the cyclase. In contrastsubstitutions in the kinase homology domainW708R and I734Tlinked to Leber congenital amaurosis prevented binding of both and Our results demonstrate that GCAPs cannot regulate RetGC1 using independent primary binding sites. InsteadGCAP1 and bind with the cyclase molecule in a mutually exclusive manner using a common or overlapping binding site(s) in the Arg-Arg portion of RetGC1and mutations in that region causing Leber congenital amaurosis blindness disrupt activation of the cyclase by both and |
Femtosecond laser corneal refractive surgery for the correction of high myopic anisometropic amblyopia in juveniles. or can be promising alternative methods to correct high myopic anisometropic amblyopia in juvenile patients who have failed with traditional approaches.To evaluate the effects of femtosecond laser-assisted in situ keratomileusis and small-incision lenticule extraction to correct high myopic anisometropic amblyopia in juvenile patients.From November 2013 to January 201533 amblyopic patients with high myopic anisometropic amblyopia were studied. (30 eyes) or (3 eyes) was performed in the amblyopic eyes. Visual acuityrefractioncontrast sensitivitystereoacuity and complications were evaluated. Patients completed follow-up examinations at 3d1mo3mo and the last follow-up time (mean 8.17±3.23mo) after surgery.The mean age at surgery was 9.04±3.04y (range 6-16y). The mean spherical equivalent in the amblyopic eyes was significantly decreased from -10.00±2.39 preoperatively to -0.06±1.06 at 1mo-0.19±1.33 at 3mo and -0.60±1.43 at approximately 8mo postoperatively for all). The mean myopic anisometropia was significantly decreased from -9.45±2.33 preoperatively to +0.37±1.48 at 1mo-0.46±1.47 at 3mo and -0.09±1.83 at approximately 8mo for all). The logarithm of the minimum angle of resolution (logMAR) for uncorrected and corrected distance visual acuity and CDVArespectively) of the amblyopic eye improved from 1.74±0.35 and 0.98±0.63 preoperatively to 0.45±0.31 and 0.41±0.33 at approximately 8mo after surgeryrespectively. The logMAR at 3d13 and 8mo postoperatively improved by means of 1.422.222.96and 4.39 linesand a gain of more than two lines accounted for 45%50%74% and 86% of all patientsrespectively. The contrast sensitivity of both amblyopic eyes and dominant eyes at 0.528 cycles per degree was significantly improved postoperatively for all). Of the 33 pediatric patientsno patients had near stereopsis preoperatively and seven patients recovered near stereopsis (400″ to 60″) at approximately 8mo after surgery. No intraoperative or postoperative complications occurred in any patient. |
Rapid and delayed death of cultured trabecular meshwork cells after selective laser trabeculoplasty. Selective laser trabeculoplasty is becoming increasingly employed to reduce elevated intraocular pressure in glaucoma patients. is known to target the ocular trabecular meshwork (TM)but the exact response mechanisms to this treatment have not been clearly delineated. Influences on cells were determined for up to 10 days post-treatment by trypan blue exclusionterminal deoxynucleotidyl transferase dUTP nick-end labeling and by morphological assessment. Furthermorehomogeneous mixtures of pigmented and non-pigmented cells were irradiated to ascertain selectivity of laser effects.At higher energy levels (1.00.75 mJ)immediate loss of cells was detected at the irradiated site. Trypan blue exclusion analysis showed that necrotic cell death subsequently occurred up to 8 hours following irradiationpeaking at 60 minutes. This was followed by delayed cell death peripheral to the irradiated area which was characteristic of apoptosis and which peaked at 2-3 days post-treatment. When mixed cultures were testedlaser treatment selectively killed pigmented cells at an energy level equivalent to the lower cell killing threshold in the initial studies (0.2 mJ) but at the higher laser energy of 0.35 mJall cells were non-selectively killed.SLT treatment killed pigmented cells in culture by a variety of processes (instant vaporizationrapid necrosisdelayed apoptosis)depending on the magnitude of the energy used and the distance from the center of the irradiated zone. These data may assist in the elucidation of the mechanism of action of the procedure on cells in situ. |
Nonresonant Raman imaging of protein distribution in single human cells. It is shown that high quality Raman imaging of the protein distribution can be obtained using confocal nonresonant Raman imaging (lambda(exc) = 647.1 nm). The results are shown for two different human cell types. Perpheral blood lymphocytes are used as an example of the fully maturated cells with a low level of nuclear transcription. Human eye lens epithelial cells are used as an example of cells with a high level of nuclear activity. The protein distribution in both cell types is completely different. The nuclear distribution of the protein largely varies in the peripheral blood lymphocyte cellswhile proteins are more homogenously distributed over the nuclear space in the eye lens epithelial cells. The imaging time is approximately 20 min for a field of view of 10 x 10 microm. The size of the sampling volume is 1.4 fL using a full width at half-maximum criterion along the z axis and a 1e criterion in the xy plane. |
severe case of Moebius syndrome with calcification on the fourth ventricular floor. We report the case of a Japanese girl with a severe type of Moebius syndrome. Her morphological features were a mask-like facelimitation of horizontal eye movementssevere bulbar palsymultiple and bilateral arthrogryposis including the elbowkneeand ankle jointsand clubfeet. After birthher general condition became worse because of repeated apneic spells and aspiration pneumonias due to dysphagia. She finally required tracheotomy. Computed tomography of the brain revealed minute calcifications on the fourth ventricle floor; this may have been due to severe damage to the brain stem. It is most likely that the various manifestations in our patient were due to disturbance of the blood supply to arteries perfusing the brain stem and to some other arteriesat a critical stage of fetal development. |
Rab10Crag and Ehbp1 regulate the basolateral transport of Na+K+ATPase in Drosophila photoreceptors. Cells in situ are often polarized and have multiple plasma membrane domains. To establish and maintain these domainspolarized transport is essentialand its impairment results in genetic disorders. Neverthelessthe underlying mechanisms of polarized transport have not been elucidated. We found that Rab10 impairment significantly reduced basolateral levels of Na+K+ATPasemislocalizing it to the stalk membranewhich is a domain of the apical plasma membrane. Furthermorethe shrunken basolateral and the expanded stalk membranes were accompanied with abnormalities in the Golgi cisternae of Rab10-impaired retinas. The deficiencies of Rab10-GEF Crag or the Rab10 effector Ehbp1 phenocopied Rab10 deficiencyindicating that CragRab10 and Ehbp1 work together for polarized trafficking of membrane proteins to the basolateral membrane. These phenotypes were similar to those seen upon deficiency of or clathrinwhich are known to be involved in the basolateral transport in other systems. AdditionallyCragRab10 and Ehbp1 colocalized with and clathrin on the trans-side of Golgi stacks. Taken togetherthese results indicate that and clathrinand CragRab10 and Ehbp1 collaborate in polarized basolateral transportpresumably in the budding process in the trans-Golgi network. |
The irre cell recognition module protein Kirre is required to form the reciprocal synaptic network of neurons in the Drosophila lamina. Each neuropil moduleor cartridgein the fly's lamina has a fixed complement of cells. Of five types of monopolar cell interneuronsonly has collaterals that invade neighboring cartridges. In the proximal laminathese collaterals form reciprocal synapses with both the of their own cartridge and the collateral branches from two other neighboring cartridges. During synaptogenesisL4 collaterals strongly express the cell adhesion protein Kirrea member of the irre cell recognition module group of proteins ( Fischbach et al.2009 Neurogenet2348-67). The authors show by mutant analysis and gene knockdown techniques that neurons develop their lamina collaterals in the absence of this cell adhesion protein. Using electron microscopy (EM)the authors demonstratehoweverthat without Kirre protein these collaterals selectively form fewer synapses. The collaterals of neurons of various genotypes reconstructed from serial-section revealed that the number of postsynaptic sites was dramatically reduced in the absence of Kirrealmost eliminating any synaptic input to neurons. significant reduction of presynaptic sites was also detected in kirre mutants and gene knockdown flies using interference. neuron reciprocal synapses are thus almost eliminated. presynaptic markerBrp-short(GFP) confirmed these data using confocal microscopy. |
The multifocal visual evoked potential. With the multifocal techniquevisual evoked potentials (VEPs) can be recorded simultaneously from many regions of the visual field. For the multifocal (mfVEP)the patient views a display that typically contains 60 sectorseach with a checkerboard pattern. The display covers about the same retinal area as the 24-2 Humphrey visual field Howeverdue to the scaling of the sectors of the mfVEP displaythe fields are sampled differently by the mfVEP and To assess local defects in the visual fieldthe mfVEP responses must be compared with normal controls. These comparisons require relatively sophisticated analyses and software. Whereas the mfVEP can be recorded relatively easily with the same equipment used to record multifocal electroretinograms (mfERGs)the software needed to perform the analysis is not yet widely available. The mfVEP is valuable for ruling out non-organic visual lossdiagnosing and following patients with optic neuritismultiple sclerosisevaluating patients with unreliable or questionable HVFsand following disease progression. When combined with the mfERGdiseases of the outer retina (before the retinal ganglion cells) can be distinguished from diseases of the ganglion cells andor optic nerve. The difficulties encountered in recording and analyzing mfVEP responses are greater than those involved in full-field testing. Thusin its current formthe mfVEP is best recorded and interpreted by ophthalmologists and electrophysiologists experienced with the technique. Howeverthis technique is developing rapidly; advances in commercial hardware and software are expected in the near future. |
case of recurrent transient monocular visual loss after receiving sildenafil. 53-year-old man was attended to the Clinic Ophthalmic CenterMansoura UniversityEgyptwith recurrent transient monocular visual loss after receiving sildenafil citrate (Viagra) for erectile dysfunction. Examination for possible risk factors revealed mild hypercholesterolemia. Family history showed that his father had suffered from bilateral nonarteritic anterior ischemic optic neuropathy Physicians might look for arteriosclerotic risk factors and family history of among predisposing risk factors before prescribing sildenafil erectile dysfunction drugs. |
Exploring spike transfer through the thalamus using hybrid artificial-biological neuronal networks. We use dynamic clamp to construct "hybrid" thalamic circuits by connecting a biological neuron in situ to silicon- or software-generated "neurons" through artificial synapses. The purpose is to explore cellular sensory gating mechanisms that regulate the transfer efficiency of signals during different sleep-wake states. Hybrid technology is applied in vitro to different paradigms such as: simulating interactions between biological thalamocortical neuronsartificial reticular thalamic inhibitory interneurons and a simulated sensory input grafting an artificial sensory input to a wholly biological thalamic network that generates spontaneous sleep-like oscillations injecting in thalamocortical neurons a background synaptic bombardment mimicking the activity of corticothalamic inputs. We show that the graded control of the strength of intrathalamic inhibitioncombined with the membrane polarization and the fluctuating synaptic noise in thalamocortical neuronsis able to govern functional shifts between different inputoutput transmission states of the thalamic gate. |
Unscheduled re-entry into the cell cycle induced by precedes cell death in nascent retinal neurones. During their early postmitotic lifea proportion of the nascent retinal ganglion cells (RGCs) are induced to die as a result of the interaction of nerve growth factor with the neurotrophin receptor p75. To analyse the mechanisms by which promotes apoptosisan in vitro culture system consisting of dissociated retinal cells was established. In this systemNGF-induced apoptosis was only observed in the presence of insulin and neurotrophin-3conditions that favour the birth of RGCs and other neurones expressing the glycoprotein The pro-apoptotic effect of on the G4-positive neurones was evident after 10 hours in vitro and was preceded by a significant upregulation of cyclin B2but not cyclin D1and the presence of mitotic nuclei in these cells. Brain-derived neurotrophic factor prevented both the increase of cyclin expression in the G4-positive neurones and the NGF-induced cell death. Finallypharmacologically blocking cell-cycle progression using the cyclin-dependent kinase inhibitor roscovitine prevented NGF-induced cell death in a dose-dependent manner. These results strongly suggest that the apoptotic signalling initiated by requires a driving stimulus manifested by the neuronal birth and is preceded by the unscheduled re-entry of postmitotic neurones into the cell cycle. |
Location of the inferior oblique muscle origin with reference to the lacrimal caruncle and its significance in oculofacial surgery. To identify the location of the inferior oblique muscle origin with reference to the lacrimal caruncle in order to facilitate safer oculofacial surgery by preventing morbidity associated with injury.Thirty-seven intact orbits of 20 embalmed Asian cadavers were dissected. The location of the medial border of the origin was determined with respect to the apex of the lacrimal caruncle. In additionthe size of the origin and the anteroposterior distance from the inferior orbital rim to the anterior border of the origin were measured.The origin was located at a mean distance of 1.2 mm lateral and 11.2 mm inferior to the apex of the lacrimal caruncle. In half of the orbitsthe origin was situated just on the vertical line through the apex of the lacrimal caruncle. The mean length and width of the origin were 4.3 and 2.7 mmrespectively. The mean anteroposterior distance from the inferior orbital rim to the origin was 1.9 mm.The lacrimal caruncle is easily identifiable and a reliable external landmark for prediction of the origin. The origin is located approximately where the vertical line through the apex of the lacrimal caruncle intersects the inferior orbital rim. |
Functional characterization of folate transport proteins in Staten's Seruminstitut rabbit corneal epithelial cell line. Folic acid uptake was studied with respect to timepHtemperaturesodiumand chloride ion dependency. Inhibition studies were conducted with structural analogsvitaminsand metabolic inhibitors. Folic acid uptake was also determined with varying concentrations of cold folic acid. Uptake kinetics was studied in the presence of various modulators of intracellular regulatory pathwaysprotein kinases and and PKC)protein tyrosine kinase (PTK)and calcium-calmodulin modulators. Ex vivo corneal permeability studies were carried out with folic acid in the presence and absence of 1 mM cold folic acid.Linear increase in folic acid uptake was observed over 30 min. The process followed saturation kinetics with apparent K(m) of 14.2 ± 0.2 nMV(max) of micro.molesminmg proteinand K(d) of min. The uptake process was found to be dependent on pHsodium ionschloride ionstemperatureand energy. Uptake was inhibited in the presence of structural analogs (cold folic acidmethyltetrahydro folateand methotrexate)but structurally unrelated vitamins did not show any effect. Membrane transport inhibitors SITSDIDSprobenecid and endocytic inhibitorcolchicine significantly inhibited the folic acid uptake indicating the involvement of receptortransporter mediated process. PKAPTKand Cacalmodulin pathways significantly regulate the process. and Western blot analysis confirmed the presence of folate receptor-α (FR-alpha) and proton-coupled folate transporter Permeability of folic acid across the rabbit cornea was cmsecand in the presence of cold folic acid it was cmsec.This work demonstrated the functional and molecular presence of FR-alpha and in epithelial cell line. |
New Therapies of Neovascular beyond Anti-VEGF Injections. Neovascular age-related macular degeneration is a leading cause of vision loss among the aging population. The current standard of care to treat neovascular age-related macular degeneration is inhibiting vascular endothelial growth factor through intravitreal injections. Recent studies have demonstrated that the tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2 (Tie2) pathway also plays a critical role in angiogenesis and vascular stability. Additionallynewly developed treatment delivery systems have been designed to greatly reduce the frequency of injections. In targeting the Tie2 pathway and utilizing a sustained release delivery systempatients may experience improved visual outcomes and a reduced burden of treatment. |
Agreement of corneal measurements between dual rotating Scheimpflug-Placido system and Placido-based topography device in normal and keratoconus eyes. Placido-based topography underestimated all topographic values except and in healthy eyes and J0maximum corneal power pointand in keratoconus eyeswith statistically significant differences in astigmatism (healthy)flat (keratoconus)axis (keratoconus)J0J45and < .05). Healthy eyes showed better agreement (95% limits of agreement: simulated -0.13 to 0.40; steep -0.30 to 0.59; flat -0.29 to 0.51; astigmatism -0.60 to 0.64; -1.15 to 1.13; -1.10 to 1.20; maximum corneal power point -0.70 to 1.17; -0.96 to 0.76 mm) than keratoconic eyes (simulated -2.84 to 4.55; steep -2.80 to 5.21; flat -3.68 to 4.70; astigmatism -1.90 to 2.95; -2.85 to 3.20; -3.21 to 3.05; maximum corneal power point -7.00 to 4.51 -1.00 to 0.88).Healthy eyes showed better agreement than keratoconus eyes between Placido-based and dual-Scheimpflug topography. Both instruments could be used interchangeably with caution in healthy eyesbut not in keratoconus management.None of the authors has a financial or proprietary interest in any material or method mentioned. |
Apoptotic effects of topical antiglaucoma medications on conjunctival epithelium in glaucoma patients. Apoptotic effects of topical antiglaucoma drugs on the conjunctival epithelial cells were found. Thirty patients were included in the first group who had received antiglaucomatous therapy before trabeculectomy. In the second group20 patients who had received no drugs before trabeculectomy were includedwhile the third group underwent only cataract surgery as control. During the surgery2 x 4 mm conjunctival samples were harvested from the upper bulbar conjunctiva. The mean apoptosis rate was calculated by determining apoptosis at conjunctival epithelium using the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling method.The mean apoptosis rate was 0.537 ± 0.369 in group 10.139 ± 0.162 in group 2and 0.078 ± 0.035 in the control group (group 3). The mean apoptosis rate was significantly higher in the first group than the other 2 groups (p = 0.0001). |
Tomographic Findings After Implantation of Ferrara Intrastromal Corneal Ring Segments in Keratoconus. Computed tomography scans of the two corneal surfaces were obtained preoperatively and postoperatively with a rotating Scheimpflug imaging system. Both corneal surfaces showed statistically significant decreases in average steep keratometry valuescorneal astigmatismelevation at the apex and at the thinnest pointmaximum elevation in the central 4-mm areaand elevation inside the 3- and 4-mm zones and at the 3-mm ring. Regarding anterior surface parametersa significant decrease was observed in flat keratometry (K1)whereas asphericity increased. On the posterior corneal surfaceno significant changes in and asphericity were observed. Poor correlation was found between visual outcomes and changes in tomographic parameters. The best correlation was obtained for anterior corneal astigmatism.ICRS implantation led to statistically significant changes in both anterior and posterior corneal surfaces. Howevercorrelation between visual outcomes and tomographic parameters was poor. Refract Surg. 2017;33:110-115. ]. |
Corneal sensation after corneal refractive surgery with small incision lenticule extraction. One eye of each patient was treated by SMILEand the fellow eye was treated by Mean outcome measures Cochet-Bonnet esthesiometrySchirmer test with anesthesiatear breakup timeand tear film osmolarity were evaluated preoperatively as well as 1 week1 month3 monthsand 6 months after surgery.Corneal sensation was reduced after both and surgeries 1 week1 monthand 3 months after surgery (p < 0.05 in both groups). Corneal sensation was significantly lower after than after at postoperative 1 week1 monthand 3 months (p < 0.01 for all points). |
Ocular motility in thalidomide embryopathy. Twenty-one individualsaged 28 to 29 yearswith documented thalidomide embryopathy were examined in Sweden. The most noteworthy ophthalmologic finding was the high prevalence of incomitant horizontal strabismusprimarily of the Duane syndrome type. Less frequently seen were cases of both marked abduction and adduction limitation similar to a gaze paresis with no observable fissure changesas well as a few cases of isolated abduction weakness or inferior oblique under-action. There were many examples of aberrant lacrimationfacial nerve palsyand ear anomalies combined with horizontal incomitant forms of strabismus. Ear and facial nerve palsies are known to occur with ingestion of thalidomide early in the sensitive period (approximately days 21 to 26 after conception). |
In vivo single-cell excitability probing of neuronal ensembles in the intact and awake developing Xenopus brain. Sensory experience can elicit long-lasting plasticity of both single neurons and ensemble neural circuit response properties during embryonic development. To investigate their relationshipone must image functional responses of large neuronal populations simultaneously with single-cell resolution. In this protocolwe describe a noninvasive approach to assay functional plasticity of individual neurons and neuronal populations in vivo using targeted infusion of calcium-sensitive dyestwo-photon microscopy and synchronized visual stimuli presentations. This technique allows visualization of approximately 200 neurons while probing visual responses in the optic tectum of awakeimmobilized Xenopus laevis tadpoles. The protocol includes visual training paradigms that elicit long-lasting potentiation or depression of functional responsesallowing investigations of population and single-neuron plasticity induced by natural sensory stimuli in the awakeintactdeveloping brain. Setup time for this protocolincluding dye injection and chamber preparationis approximately 2 h. Excitability probing experiments can then be performed for at least 3 h. |
The burden of non-infectious intraocular inflammatory eye diseases: a systematic literature review. Non-infectious inflammatory eye diseases (IEDs)although rareare complex and varied and may result in detrimental effects. systematic literature review was conducted on the clinical outcome and economic burden of IED.The Ovid search platform (Wolters Kluwer) was used to access scientific literature databasesincluding MEDLINEEmbaseCochrane librariesHealth Technology Assessment and the Economic Evaluation database. Patients experienced considerable morbiditymuch of which was associated with corticosteroid use. The average annual healthcare costs of patients with were $13,728 to $32,268 in 2009 dollarswhich amounted to 3.1 to 8.3 times that of patients without Steroid-releasing intraocular implants were associated with higher up-front costsclose monitoring requirementspotential for implant removal and increased rates of adverse ocular events than systemic steroids.IEDs are rare and complex conditions that threaten eyesight and impose considerable morbidity as well as a substantial economic burden. |
Role of Cataract Surgery in the Management of Glaucoma. leading cause of blindnessglaucoma is estimated to affect 60.5 million people worldwidewith a projected increase to 79.6 million by 2020. Cataract surgery is the most commonly performed ophthalmic surgerywith the anticipated number of people requiring cataract surgery worldwide expected to rise to 30.1 million by the year 2020a 50% increase from 2000. Cataract and glaucoma are both more prevalent among the elderly population and commonly coexist. This review will discuss the effect of cataract surgery on glaucoma treatment in various patient populations. |
Static roll and pitch in the monkey: shift and rotation of Listing's plane. In three rhesus monkeys three-dimensional eye positions were measured with the dual search coil technique. Recordings of spontaneous eye movements were made in the light and in the darkwith the monkeys in different static roll or pitch positions. Eye positions were expressed as rotation vectors. In all static positions eye rotation vectors were confined to a planei.e. Listing's plane was conserved. Tilt about the roll axis shifted the plane along this axisi.e. a constant torsional component was added to all eye positions. Tilt about the pitch axis changed the pitch angle of Listing's plane. |
Telephone talk: effects of two access methods on phone call success. The slower and unnatural timing of speech inherent to speech-generating devices (SGDs) can be a barrier to successful aided telephone calls. The timing of message delivery when using an may vary depending on the type of access method used. We measured the difference in the success rate of telephone calls made with an either using switch scanning or direct selection with eye gaze. The scripted callsasking for directionswere placed to 100 randomly selected businesses. Analysis showed a statistically significant difference in the success rate between the two conditionswith eye gaze access resulting in more successful calls. |
Three-dimensional digital visualization of phacoemulsification and intraocular lens implantation. The heads-up vision system is suitable and safe for cataract phacoemulsification and implantation. Ocular and surgical parameters such as surgery timepre and postoperative best-corrected visual acuity (BCVA)and corneal endothelial cells density were recorded and statistically analyzed.The result showed significant postoperative improvement of in both groups. There was no difference in either mean surgery time or postoperative mean endothelial cell density between the group and the conventional group. No major complication occurred during surgery in either group. |
Substance P-immunoreactive neurons in the human retina. Substance is a neuropeptide that acts as a neurotransmitter or a neuromodulator in the retina. We have used an antiserum to to immunostain neurons in postmortem human retinae. Immunostained retinae were processed with the avidin-biotin complex to visualize the cells either whole mounted in glycerol or embedded in plastic. Some retinae were also sectioned at 20 microns in order to obtain radial views of stained cells. amacrine cells stain intensely and appear to be of a single type in the human retina. They are large-field cells with large cell bodies (16 microns diameter) lying in normal or displaced positions on either side of the inner plexiform layer Their sturdyspinyand appendage-bearing dendrites stratify in stratum 3 of the IPLwhere many overlappingfine dendrites intermingle to form a plexus of stained processes. Either cell bodies or primary dendrites emit an "axon-like" process thattypicallydivides into two longfine processeswhich run in opposite directions for hundreds of micrometers in and before disappearing as distinct entities in the stained plexus in Longfine dendrites also pass from the dendritic plexus to run in and down to the nerve fiber layer to end as large varicosities at blood vessel walls. In additionfine processes are emitted from the dendritic plexus that runs in S1and some pass up to the outer plexiform layer to run therein for short distances. The amacrine cell has many similarities to the thornytype 2 amacrine cells described from Golgi studies. In addition to the amacrine cellsa presumed ganglion cell type is faintly immunoreactive. Its 20-22 microns cell body gives rise to a radiatesparsely branchedwide-spreading dendritic tree running in Its dendrites and cell body become enveloped by the more intensely processes and boutons from the amacrine cell type. |
[Clinical features and therapy of uveitis in childhood]. Introduction: Uveitis is characterized by inflammation of the middle layer of the eye. Its overall incidence is low. Autoimmune diseases and infections are the most common underlying diseases. Out of the autoimmune diseasesjuvenile idiopathic arthritis is associated most frequently with uveitis. The topical ophthalmological treatment may fail in a significant proportion of the patients and immunomodulatory therapy may be required. Results: The mean age of the patients was 9.3 years. Boys and girls were equally affected with an exception of patients with juvenile idiopathic arthritis where female predominance was found. An underlying disease could be identified in 60% of the cases . Uveitis was associated in 12 patients with juvenile idiopathic arthritisin 2 patients with Behcet's disease and in a single case with inflammatory bowel disease. Infections have been proven in 5 patients. The autoimmune diseases caused an eye inflammation typically in anterior localizationin contrast to the infections that resulted in posterior uveitis. The majority of the patients required systemic treatment. 3 of them received systemic corticosteroid and 18 patients methotrexate as disease-modifying antirheumatic drug. 13 children with severe disease activity required biological therapy (adalimumab injection). Remission could be achieved in 1.45 months. Conclusion: Pediatric uveitis is of great importance. Early diagnosisadequate therapy and follow-up require multidisciplinary cooperation. Orv Hetil. 2019; 160: 1335-1339. |
Fukutin and alpha-dystroglycanopathies. Fukuyama-type congenital muscular dystrophy (FCMD)Walker-Warburg syndrome (WWS)and muscle-eye-brain disease are clinically similar autosomal recessive disorders characterized by congenital muscular dystrophylissencephalyand eye anomalies. We identified the gene for and MEBwhich encodes the fukutin protein and the protein O-linked mannose beta12-N-acetylglucosaminyltransferase (POMGnT1)respectively. Recent studies have revealed that posttranslational modification of alpha-dystroglycan is associated with these congenital muscular dystrophies with brain malformations. All are characterized by hypoglycosylated alpha-dystroglycan. Fukutin's function and the relation with other alpha-dystroglycanopathies are discussed. |
Next-Generation Sequencing Identifies Novel Variants in Patients with Late-Onset Dominant Optic Atrophy. Dominant Optic Atrophy is one of the most common inherited mitochondrial diseasesleading to blindness. It is caused by the chronic degeneration of the retinal ganglion cells (RGCs) and their axons forming the optic nerve. Until nowDOA has been mainly associated with genes encoding proteins involved in mitochondrial network dynamics. Using next-generation and exome sequencingwe identified for the first time heterozygous variants having a causative role in the pathology of late-onset primary in five patients. encodes an α subunit of the mitochondrial peptidase (MPP)responsible for the cleavage and maturation of the mitochondrial precursor proteins imported from the cytoplasm into mitochondria. RecentlyPMPCA has been identified as the gene responsible for Autosomal Recessive Cerebellar Ataxia type 2 and another severe recessive mitochondrial disease. Functional assays on patients’ fibroblasts show a hyperconnection of the mitochondrial network and revealed that frameshift variants reduced α-MPP levelswhile not significantly affecting the respiratory machinery. These results suggest that alterations in mitochondrial peptidase function can affect the fusion-fission balancea key element in maintaining the physiology of retinal ganglion cellsand consequently lead to their progressive degeneration. |
Change of water-soluble-proteinurea-soluble-protein and membrane intrinsic protein in human senile cataract. The water-insoluble proteinwhether in quantity or in qualityplays an important role in cataract formation.To analyze the change of water-soluble-protein (WSP)urea-soluble-protein and membrane intrinsic protein in human senile cataract.The water-soluble-fractions were prepared basically according to the method of Kibbelearet al. The urea-soluble-fractions were prepared basically according to the method of Kibbelearet al. Lens fiber cell membranes were purified basically according to the method of Russellet al. were performed according to the procedure of Laemmiliet al. using resolving gel 13% and 3% stacking gel.The was fractionated into alpha-beta- and gamma-crystallin components. In nuclear cataractous lenses alpha- and B-crystallin increasewhile r-crystallin decrease. The from clear lenses contains mainly alpha beta chains of 22KDwhereas in cataractous lensesespecially in nuclear cataractous lensesthe relative amount of the 28- and polypeptide (the components of beta-crystallin) increased markedly. Lens fiber cell MIPclear lens and cataract lens contained the main polypeptide of and |
Transport of fluorescein in the rabbit eye after treatment with sodium iodate. The outward active transport and the inward permeability of the blood-retinal barrier were studied in the rabbit eye after i.v. administration of sodium iodate. The active transport was evaluated from the half-time of disappearance of the vitreous fluorescein following intravitreal administrationand the inward permeability was evaluated from the vitreous concentration of fluorescein monoglucuronide after i.v. administration. The half-time of the vitreous fluorescein was 3.5 +- 0.3 (mean +- hrand 3.9 +- 0.2 hr before and within 6 hr after iodate administrationrespectively. After 24 hrthe half-time was 11.7 +- 1.7 hrsimilar to that of fluorescein monoglucuronide12.0 +- 2.7 hr. The vitreous and the anterior chamber concentration of fluorescein monoglucuronide was measured at 1 hr after the i.v. dye injection. The vitreous concentration in the rabbits given iodate 3 hr before the dye injection was significantly greater than in the normal eyeswhile the anterior chamber concentration was not different. Since fluorescein is rapidly metabolized to fluorescein monoglucuronidedifferences in parameters determined using systemic fluorescein under two treatments or in disease states may be the result of alteration of the dynamics of fluoresceinfluorescein monoglucuronideor both. |
Molecular profiling of resident and infiltrating mononuclear phagocytes during rapid adult retinal degeneration using single-cell sequencing. Neuroinflammation commonly accompanies neurodegenerationbut the specific roles of resident and infiltrating immune cells during degeneration remains controversial. Much of the difficulty in assessing myeloid cell-specific functions during disease progression arises from the inability to clearly distinguish between activated microglia and bone marrow-derived monocytes and macrophages in various stages of differentiation and activation within the central nervous system. Using an inducible model of photoreceptor cell deathwe investigated the prevalence of infiltrating monocytes and macrophage subpopulations after the initiation of degeneration in the mouse retina. In vivo retinal imaging revealed infiltration of leukocytes across retinal vessels and into the parenchyma within 48 hours of photoreceptor degeneration. Immunohistochemistry and flow cytometry confirmed and characterized these leukocytes as CD11b+CD45+ cells. Single-cell mRNA sequencing of the entire CD11b+CD45+ population revealed the presence of resting microgliaactivated microgliamonocytesand macrophages as well as 12 distinct subpopulations within these four major cell classes. Our results demonstrate a previously immeasurable degree of molecular heterogeneity in the innate immune response to cell-autonomous degeneration within the central nervous system and highlight the necessity of unbiased high-throughput and high-dimensional molecular techniques like scRNAseq to understand the complex and changing landscape of immune responders during disease progression. |
Fast Phenomics in Vineyards: Development of GRoverthe Grapevine Roverand LiDAR for Assessing Grapevine Traits in the Field. light detection and ranging (LiDAR) radar mounted on GRover was capable of producing precise (±3 mm) point clouds of vine rows. Vineyard scans of the grapevine variety Shiraz grown under different management systems at two separate locations have demonstrated that GRover is able to successfully reproduce a variety of vine structures. Correlations of pruning weight and vine wood (trunk and cordon) volume with LiDAR scans have resulted in high coefficients of determination = 0.91 for pruning weight; 0.76 for wood volume). This is the first time that a LiDAR of this type has been extensively tested in vineyards. Its high scanning rateeye safe laser and ability to distinguish tissue types make it an appealing option for further development to offer breedersand potentially growersquantified measurements of traits that otherwise would be difficult to determine. |
[Retinal nerve fiber layer thickness in glaucomatous eyes. To investigate the retinal nerve fiber layer thickness in glaucomatous eyes using Optical Coherence Tomography To compare the thickness with visual field damage (Humphrey field analyzer).The mean thickness in glaucomatous eyes (n = 80) was compared with age-matched normal eyes (n = 40). Three circular scans were obtained for each eye using (3.4 mm diameter). In each eyeaverage quadrants and 12 meridians were calculated and compared. The superior-inferior asymmetry of was studied. The average thickness was compared with mean deviation and mean standard deviation of 24-2 visual field program.Mean was significantly thinner in glaucomatous eyes than in normal eyes (p<0.001). The thickness was decrease in the 4 quadrants and 11 of 12 meridians studied in glaucomatous eyes (p<0.05). The superior-inferior asymmetry showed a significant difference in thickness at 30 degrees central meridian (p<0.05). Mean thickness was significantly associated with and of visual field (p<0.001) in glaucomatous eyes.OCT revealed significant quantitative differences in thickness between glaucomatous and normal eyes. showed a considerable measurements overlap between glaucomatous and normal eyeswhich can limit the sensitivity and specificity of this instrument (Arch Soc Esp Oftalmol 2002; 77: 435-442). |
Chlamydiosis in birds in Great Britain. 2. Isolations of Chlamydia psittaci from birds sampled between 1976 and 1984. total of 1531 diagnostic submissions from birds were examined by culture for the presence of Chlamydia psittaci between June 1976 and December 1984 by growth in 929 clone mouse fibroblast cellspretreated with an inhibitor of cell divisionfollowed by direct immunofluorescence microscopy. Of these196 were found positive. The continued importance of psittacine birds as potential sources of infection was shown by the high number of positives obtained from birds of that order. The percentage of submissions found positive was highest in parakeets and was fairly high in psittacines as a group but the latter figure was exceeded by the group of collared doves (Streptopelia decaocto) and wood pigeons (Columba palumbus) . Domestic poultry generally gave low ratesturkeys being the highest. Both the numbers of submissions and their rates of positives increased between 1980 and 1984. Comparing the isolation rates from the various organs sampledthe intestines gave the highest rate (20.4 per cent positive)closely followed by the other internal sites. The superficial swabbed sites (eyenasal cavitycloaca) gave lower rates. |
Anaerobic flora of the conjunctival sac in patients with and with anophthalmia compared with normal eyes. Relatively few investigations of anaerobic bacteria as ocular flora have been conductedand their results have been contradictory. The conjunctival sacs of 22 normal subjects and of 14 patients with acquired immunodeficiency syndromeand 22 anophthalmic sockets were cultured for anaerobic bacteria Thirty-four of the 44 eyes of normal subjects harbored anaerobic bacteria; Propionibacterium acnes was present in 28 eyes Lactobacillus species in 6 eyes and Veillonella species in 7 eyes . The finding were very similar for anophthalmic sockets (p = 0.01)with 17 of the 22 sockets harboring anaerobes; Propionibacterium acnes was the organism identified in 16 of these sockets; Veillonella was identified in 4 Peptococcus niger in 3 and granulosum in 2 of these sockets. Acquired immunodeficiency syndrome patients had the highest incidence of anaerobic organismswith positive cultures obtained from 24 of the 28 eyes. Propionibacterium species were isolated from 16 of these eyes. Clostridium species from 10 eyes and Actinomyces species from 8 eyes. It thus appears that anaerobic organisms are common flora in normal conjunctival sacs and in anophthalmic socketsas well as in the sacs of acquired immunodeficiency syndrome patientsbut the latter group had a higher incidence (x2 = 0.87) and a spectrum of organisms that was different from that of the other two groups. |
Zinc Monotherapy as an Alternative Treatment Option for Decompensated Liver Disease due to Wilson Disease? Wilson disease is a rare metabolic disorder involving copper metabolismand patients may present with a variable degree of hepaticneurologicand psychiatric manifestations. In the case of hepatic presentationtreatment is usually initiated with potentially toxic copper chelators (D-penicillamine or Trenton). Although zinc is of low toxicity and low cost for treatment of Wilson diseaseit has been limited to the adjunctive as a single maintenance drug or for asymptomatic patients. The use of zinc monotherapy in patients suffering from a severe liver disease was not well studied. In our case reportwe describe a pediatric patient who presented with liver failure and the use of zinc monotherapy in patients with severe hepatic manifestations. Case presentation. 15-year-old male patient from Ethiopia presented with generalized body swelling (edema and ascites) with yellowish discoloration of his eyes and easy fatigability. He had hyperbilirubinemiacoagulopathyhypoalbuminemiaand deranged liver enzymes. He had a Keyser-Fleischer ring visible with the naked eyewhich was confirmed by slit-lamp examination. He had very low serum ceruloplasmin (<8 mgL) and high 24-hour urine copper (150 mcgdl). In accordance with the scoring system proposed by the 8th International Meeting on Wilson Disease and Menkes Diseasea diagnosis of Wilson disease was made. Zinc monotherapy with low copper diet was initiated for decompensated liver disease due to Wilson disease because of the inaccessibility of chelators (D-penicillamine or Trientine). After months of treatment with zincthe patient experienced normalization of hepatic synthetic function and resolution of hypoalbuminemia and coagulopathy. The patient had also clinically stabilized (asciteslower extremity swellingedemaand jaundice were improved. Currentlythe patient is on follow-up almost for the last four years in the gastrointestinal clinic. Our case shows that zinc has the potential for treatment in improving liver function. Though zinc has its own side effectsit is important and maybe an alternative treatment option in those with limited resources (not able to access chelators). |
standard enucleation procedure was performedand each patient was randomized to receive either Medpor or Medpor-Plus orbital implant with anterior scleral cap technique. Gadolinium-enhanced3-Tesla was performed at 1.5 months3 monthsand 4.5 months following surgery. Implant vascularization was calculated in axialcoronaland sagittal planes with manual planimetric method using postcontrast T1-weighted Digital Imaging and Communications in Medicine images.The mean area of implant vascularization at 1.5 months3 monthsand 4.5 months for Medpor implants was 58%70%and 75%respectivelyand for Medpor-Plus implants was 69%76%and 85%respectively. The mean vascularization of Medpor-Plus implants was more than Medpor implants at 1.5 months (p = 0.008)3 months (p = 0.09)and 4.5 months (p = 0.003). The difference between the 2 groups assessed by repeated measures analysis of variance was statistically significant (p < 0.0001). During the mean follow-up of 36.7 months (range18-43 months)1 patient in the Medpor group had implant exposure that responded to scleral patch graft.Implant vascularization is faster with Medpor-Plus implants compared with Medpor implants when assessed by a planimetric method using 3 Tesla The addition of synthetic bone graft particulate (Novabone) to porous polyethylene may enhance implant vascularization. |
Correction to: zebrafish model of foxe3 deficiency demonstrates lens and eye defects with dysregulation of key genes involved in cataract formation in humans. The authors noticed that Fig. and aspect ratios appeared sub-optimal in the online published version. This has now been changed. |
programme to improve quality of care for patients with chronic diseasesKazakhstan. This intensivesupportivemultifaceted programme was associated with significant improvements in quality of care for patients with chronic disease. Further investment in coaching capacity is needed to extend the programme nationally.To evaluate the effect of a disease management programme in Kazakhstan on quality indicators for patients with hypertensiondiabetes and chronic heart failure.A supportiveinterdisciplinaryquality improvement programme was implemented between November 2014 and November 2015 at seven polyclinics in Pavlodar and Petropavlovsk. Quality improvement teams were established at each clinic and quality improvement tools were introducedincluding patient flowsheetsdecision support toolspatient registriesa patient recall processsupport for patient self-management and patient follow-up with intensity adjusted for level of disease control. Clinic teams met for four 3-day interactive learning sessions within 1 yearwith additional coaching visits. Implementation was managed by five local coordinators and consultants trained by international consultants. National and regional steering committees monitored progress.Between July and October 2015the proportion of hypertensive patients with the recommended blood pressure increased from 24% to 56% . Among patients with diabetesthe proportion who recently underwent eye examinations increased from 26% to 71% ; the proportion who had their low-density lipoprotein cholesterol measured increased from 57% to 85% ; and the proportion who had their albumin : creatinine ratio measured increased from 11% to 49% . The proportion of chronic heart failure patients who underwent echocardiography rose from 91% to 99% . All patients set themselves self-management goals. |
The influence of corneal collagen cross-linking on anterior chamber in keratoconus. The preoperative (T0)postoperative 6th month (T1)and postoperative 1st year anterior chamber volume (ACV)anterior chamber angle (ACA)and anterior chamber depth scheimpflug imaging values were obtained for each eye.The mean value was 182.79 ± 36.68 mmwhile the value was 201.25 ± 41.73 mm3 and the value was 208.40 ± 42.69 mm3 with a statistically significant difference between the periods = 0.001). The mean value was 38.64° ±5.85°increasing to 41.45° ±4.83° in the and 42.10° ± 4.84° in the The value was significantly lower than the post-CXL values = 0.003). The mean value was 3.73 ± 0.29 mm at the and 3.82 ± 0.38 mm at the and 3.84 ± 0.36 mm at the The pre-CXL values were significantly lower than the post-CXL values = 0.001).The improvement of corneal parameters by in keratoconus patients can have a positive effect on anterior chamber parameters as well. This effect becomes marked at the postoperative first 6-month evaluation. |
Frequent Mutation in the Gene Causing Hyperferritinemia Cataract Syndrome in Turkish Population Is c.-160A>G. In the Turkish populationthe prevalence of is about 1100,000 and the commonly observed mutation is c.-160A>G mutation.Hyperferritinemia cataract syndrome is an autosomal dominantly inherited disease characterized by increased serum ferritin levels and bilateral cataract formation in the early period of life. Heterozygote mutations in the 5’ untranslated region of the L-ferritin gene have been reported to cause this disease. Exonsexon-intron boundariesand 5’ and 3’ untranslated regions of were sequenced using the Sanger sequencing method.The femalemale ratio of the patients was 710. All of the patients were found to have c.-160A>G heterozygous mutation in the gene. |
Recombinant human serum albumin for corneal preservation. The tissues were assessed at day 0; after 6 days of preservation at room temperature in Cornea Trans® and Cornea Prep ; after 28 days at in Cornea Syn® [with rHSA] and Cornea Max® [with foetal calf serum and; 4-day post deswelling in Cornea Trans® and Cornea Jet® . Thickness was determined with optical coherence tomography and transparency with a validatedcustom device. Morphologyendothelial cell density and mortality were observed after treating the tissues with Trypan blue and sucrose. Glucose uptake by the cells was analysed. Data were compared using non-parametric paired Wilcoxon tests with p < 0.05 deemed significant. Histology using periodic acid-schiff (PAS)expressions of p63CK12αSMA and were analysedand cell apoptosis postpreservation was studied.Corneas stored in synthetic media showed a higher and statistically significant value as compared to serum-based media in terms of viable endothelial cell density (VECD)mortalitymorphology and glucose uptake postpreservation. Histology showed presence of all the layersall the markers were expressedand no apoptosis was observed in either media. |
In this techniquethe dislocated is not taken in the anterior segment before the scleral fixation. The haptics are threaded into the needle directly in the vitreous cavity during the vitrectomy. This is a short cut Yamane technique for posteriorly dislocated three-piece IOLs. This technique may shorten the surgical time and minimize surgical trauma in cases with posteriorly dislocated three-piece IOL.Double-needle intrascleral haptic fixation (Yamane) technique is a minimally invasive method for posterior chamber intraocular lens fixation in the setting of absent or inadequate capsule support. modified intravitreal needle technique is herein described for the management of three piece IOLs which are dislocated into the vitreous cavity.In this techniqueafter completing pars plana vitrectomyunder the noncontact ophthalmomicroscopethe haptic of the dislocated is docked directly in the vitreous cavity into a needle which is inserted through a transconjunctival tunneled scleral incision 2 mm. from the corneal limbusand externalized from the conjunctiva and fixated sclerally.The technique is described with a case report. male patient of 65 years old who underwent a complicated cataract surgery was operated using this technique. No preoperative or postoperative complication was seen. |
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