bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of intraoperative keratometry in predicting outcome of radial keratotomy
Authors: Olsen Hanne , Ehlers Niels , Hjortdal Jesper Ø.
Published: May 2009

Purpose: To investigate whether the immediate change in corneal power during radial keratotomy correlates with the long‐term postoperative change in subjective refraction, and thereby being predictive for refractive outcome.

Methods: Manual keratometry was performed on 45 consecutively operated eyes of 45 young persons with myopia of 5 dioptres and less and immediately after radial keratotomy. Automated keratometry and subjective spherical equivalent refraction were investigated during a follow‐up period of 6 months and correlated to the intraoperative keratometric measurements.

Results: On average, the majority of the change in corneal curvature after radial keratotomy took place within 1 min. There was no correlation between the intraoperative curvature change and the changes in curvature measured up to 6 months after surgery. There was a weak significant positive correlation between intraoperative curvature change and the change in subjective refraction at 6 months after surgery (R = 0.48, p<0.01). The prediction error in estimating subjective refractive changes from intraoperative keratometry changes was, however, similar in patients who had bilateral radial keratotomy. Inclusion of such fellow‐eye information together with the age of the patient in a multiple linear regression analysis increased the correlation coefficient from 0.48 to 0.75.

Conclusions: The change in central corneal curvature takes place within minutes after corneal incision. As a single parameter, intraoperative keratometry cannot be used for titrating surgery. Information from the results of first eye radial keratotomy surgery with intraoperative keratometry is, however, predictive for radial keratotomy in the second eye. These findings suggest that a large source to refractive variability after radial keratotomy is related to individual patient factors, such as corneal biomechanics and wound healing.
Photorefractive keratectomy for low myopia at 6 mm treatment diameter
Authors: Hamberg‐Nyström Heléne L. , Fagerholm Per P. , Tengroth Björn T.
Published: May 2009

Purpose: The aim of the retrospective study was to evaluate the algorithms and the surgical performance of two excimer lasers; the VISX 20/20 and the Summit Omnimed.

Methods: Twenty patients were treated with the VISX‐laser and 20 with the Summit‐laser. The indications were myopia between ‐1 to ‐6 diopters which also allowed correction of astigmatism up to ‐ 2 in the VISX patients group. The treatment diameter was 6 mm and the follow‐up time was 12 months. The parameters studied were visual acuity uncorrected and corrected, contrast sensitivity in light, dark and glare, endothelial cell count, corneal topography, and subjective estimation of dark vision problems.

Results: Both groups showed the same median refraction, ‐ 0.3 diopters. All the Summit patients had uncorrected visual acuity of 0.7 or better. In the VISX group 17 patients saw ≥ 0.7 uncorrected and all patients saw 0.5 or better s.c. The remaining result parameters showed no statistical differences between the two groups.

Conclusion: The study does not lend conclusive support for any difference between the results obtained by the two lasers.
A comparative study of polyacrylic acid (Viscotears®) liquid gel versus polyvinylalcohol in the treatment of dry eyes
Authors: Brodwall J. , Alme G. , Gedde‐Dahl S. , Smith J. , Lilliedahl N. P. , Kunz P. A. , Sunderraj P.
Published: May 2009

We conducted a prospective, randomised, single‐masked study comparing the safety and efficacy of polyacrylic acid 0.2% (PAA) and polyvinylalcohol 1.4% (PVA) in 85 patients (PAA 43, PVA 42) with dry eyes. The two groups were similar in patient demographics and study parameters at baseline. With treatment, the reduction in total symptoms (gritty or foreign body sensation, burning sensation, dry eye sensation, photophobia, others) and signs (conjunctival hyperaemia, ciliary injection, corneal and conjunctival epithelial staining) score on PAA was significantly greater than that on PVA at both two and four weeks. The daily frequency of instillation of PAA was significantly less than that of PVA on 16 of the 27 (59%) study days. For overall local tolerance there was a significant preference for PAA compared to PVA by both patients and doctors. Only one patient on each treatment had an adverse event and neither was serious. PAA (Viscotears®) was as safe as, but better tolerated and more effective than PVA in the treatment of dry eye conditions.
Anthrax as the cause of preseptal cellulitis
Authors: Çelebi Serdal , Çelebi Harika , Çeliker Ülkü Ö , Kandemir Baran , Alagöz Gürsoy , Esmerligil Serhan
Published: May 2009

Anthrax is an infectious disease caused by Bacillus anthracis. It is primarily a disease of domestic animals such as cattle, goats, and sheep; but humans can rarely be infected by contact with infected animals or contaminated animal products. Our case is a 4–year‐old boy who was initially diagnosed as preseptal cellulitis, but later he showed the characteristic anthrax lesions with a black necrotic eschar. Scrapings from the necrotic tissue showed gram positive rods and culture grew Bacillus anthracis. The patient responded to intravenous administration of penicillin G, and the lesions resolved, leaving a scar on the right upper eyelid. Eyelid involvement of anthrax is rarely seen in clinical practice, but should be considered in differential diagnosis.
Silicone oil removal: Results, risks and complications
Authors: Scholda Christoph , Egger Stefan , Lakits Adalbert , Haddad Raja
Published: May 2009

Purpose: We studied the results and complications of silicone oil removal applying basic criteria for the selection of eyes.

Methods: The criteria for oil removal: 1. Completely attached retina for at least 4 weeks, 2. Absence of tractions and active proliferations, 3. Preoperative vision weeks, 2. Absence of tractions and active proliferations, 3. Preoperative vision > 0.01. The oil was removed from 90 of 261 oil filled eyes (removal rate: 34.5%). 83 eyes were included in the further study. Follow‐up: 1.3–62.5 months (mean 15.7).

Results: Visual acuity improved (≥ 1 line) in 40 of the 83 eyes (48.2%), remained unchanged in 22 eyes (26.5%) and deteriorated (≥ 1 line) in 21 eyes (25.3%). Complications: reproliferations (42.2%), retinal detachment (20.5%), pressure rises (27.7%), lens opacification (36.7%), severe keratopathy (8.4%).

Conclusion: Silicone oil removal has a distinct rate of complications, despite pre‐operative selection of eyes with a better prognosis. Reduction of reproliferations and weighing of risk and benefit could improve the results.
Myopia among the Inuit population of East Greenland
Authors: Norn Mogens
Published: May 2009

Purpose: To follow the refraction values in an indigenous population group over the course of the past 50 years.

Method: Case records from a population investigation carried out in Ammasalik, East Greeland, by Erik Skeller in 1950 were studied initially, a total of 1123 eyes were examined by sciascopy and 244 eyes could be followed sufficiently until about 1990–94.

Result: The mean refraction was initially +0.08D, while at the last examination the mean had increased to +0.69D. Initially, there was no myopia, defined as at least −1.5D, and at follow‐up it was a maximum of 1%, and presumably due to immature cataract. A tendency to myopia (<−1.5D) was found initially in 36%, but in only 22% at follow‐up.

Conclusion: The myopinizing factor in East Greenland has not affected persons born prior to 1942, even if they had a tendency to myopia (<−1.5D).
Quantitative study of the effect of dacryocystorhinostomy on lacrimal drainage
Authors: Malbouisson Jorge Mario Carvalho , Bittar Marcos Daniel Ramos , Obeid Habib Nahmatallah , Guimaräes Fernando Cenci , Cruz Antonio Augusto Velascoe
Published: May 2009

Using scintigraphy, we have studied the lacrimal drainage from the conjunctival sac of normal subjects and patients who have undergone dacryocystorhinostomy. A mathematical model of drainage was constructed that accurately described the complete activity curves for both groups. The initial rate of drainage was shown to be a relevant parameter to characterize drainage, and it was found to be different from normals to patients, indicating that the lacrimal pump mechanism is affected by dacryocystorhinostomy.
The eye and its diseases in Ancient Egypt
Authors: Andersen S. Ry
Published: May 2009

Based on a study of mummies, skeletons, burial rites, medical instruments, medicaments, literature and objets d'art from Ancient Egypt before the Hellenistic Period, the understanding of the eye, its diseases and their treatment at that time is described. Magic spells, religious rites and medical treatments, especially with eye ointments, were probably used often complementary to one another. We must be very cautious about our conclusions in regard to the effectiveness of the treatments. Eye diseases have been depicted only exceptionally in Egyptian art, except for blindness and ‘symbolic blindness’.
Long‐distance dispersal of seeds in the fire‐tolerant shrubBanksia attenuata
Authors: He Tianhua , Lamont Byron B. , Krauss Siegfried L. , Enright Neal J. , Miller Ben P.
Published: May 2009

Long‐distance dispersal (LDD) of seeds enables alleles, individuals and species of plants to (re)colonize suitable but remote habitats.Banksia attenuatais a long‐lived resprouting shrub restricted to dune crests in fire‐prone sclerophyll shrublands of the Eneabba sandplain, southwestern Australia. Highly polymorphic microsatellite DNA genetic markers and population assignment tests were employed to identify LDD immigrants among 788 individuals from 27 stands ofB. attenuatacomprising a metapopulation. Of the 487 (61.8% of the total) individuals unambiguously assigned to a unique source population, 27 (5.5%) were identified as immigrants by assignment to a known population other than that from which they were sampled, while the remaining 460 were assigned to the population from which they were sampled. The distance between source and sink populations for these immigrants ranged from 0.2 to 2.6 km, averaging 1.4 km, and broadly trending in the direction of seasonal winds. These results suggest thatB. attenuatahas similar long‐distance seed dispersal properties as its co‐occurring shorter‐lived and fire‐sensitive congener,B. hookeriana, despite fewer, larger and less mobile seeds. The frequency and distance of LDD for seeds observed in both species (5.5–6.8%) helps explain the persistence of populations on these geographically isolated dunes, where they are subject to local extinction from recurrent fire and severe summer drought, and will remain important under predicted climate change conditions. Analysis also revealed that species richness of the functional group to whichB. attenuatabelongs was positively correlated with the number of immigrants identified per dune, and such correlation was likely driven by environmental properties of the dunes, particularly water availability.
Progressive stridor: could it be a congenital cystic lung disease?
Authors: Zedan M , Elgamal MA , Zalata K , Nasef N , Fouda A
Published: May 2009

Bronchogenic cyst of the mediastinum, a cause of stridor early in life, is the result of abnormal budding of the ventral segment of the primitive foregut. Bronchogenic cysts are often asymptomatic in older children and adults. However, symptomatic cases usually manifest early in life with cough, stridor or wheezing due to airway compression. We report a female infant aged 4.5 months with a normal full‐term pregnancy, who developed respiratory distress with stridor. This stridor was preceded by a history of slowly progressive noisy breathing. Physical examination revealed evidence of bilateral obstructive emphysema. Chest radiograph revealed bilateral overinflation. Fibro‐optic bronchoscopy revealed posterior mediastinal compression. Possibility of congenital cystic lung disease (CCLD) was considered, emphasizing the value of computed tomography (CT) chest, which revealed a cyst probably bronchogenic. Surgical excision was performed with evident histological confirmation of bronchogenic cyst.

Conclusion:  we highlight that in any infant, presented with slowly progressive noisy breathing in the first year of life, CCLD should be considered in the differential diagnosis even with normal X‐ray chest. CT chest should be performed for exclusion or diagnosis of the case.
WITTGENSTEIN’S CONTEXTUALIST APPROACH TO JUDGING “SOUND” TEACHING: ESCAPING ENTHRALLMENT IN CRITERIA‐BASED ASSESSMENTS
Authors: Stickney Jeff Alan
Published: May 2009

Abstract Comparing the early, analytic attempt to define “sound” teaching with the current use of criteria‐based rating schemes, Jeff Stickney turns to Wittgenstein’s holistic, contextualist approach to judging teaching against its complex “background” within our form of life. To exemplify this approach, Stickney presents cases of classroom practice (reexplanation), auditioning dance students, teacher inspection, and mentoring student teachers. These examples highlight problems with the epistemological and criterial construal of teaching, in that both sets of rules tend to constrict unnecessarily the ranges of “reasonable” practice. Shifting to the contextualist approach, according to Stickney, reveals these occluded, political aspects of assessing the “soundness” of teaching and invites a renegotiation of arbitrary limits.
PHILOSOPHY OF EDUCATION TODAY
Authors: Chambliss J.J.
Published: May 2009

Abstract In this review essay J.J. Chambliss assesses the current state of the field of philosophy of education through analysis of four recent edited compilations: Randall Curren’s A Companion to Philosophy of Education; Nigel Blake, Paul Smeyers, Richard Smith, and Paul Standish’s The Blackwell Guide to Philosophy of Education; Wilfred Carr’s The RoutledgeFalmer Reader in Philosophy of Education; and Randall Curren’s Philosophy of Education: An Anthology. He considers how these books address the question of what constitutes philosophy of education, with specific reference to the approach each takes to two topics: feminism and practical reason. Then, taking as a starting point Carr’s insight that a revised history of the philosophy of education could help us better understand the discipline, Chambliss traces the evolution of philosophy of education in the United States from the discipline’s origins, dominated by a tension between Empiricism and Idealism; to the “schools of philosophy” approach — that is, applying a set of beliefs derived from a particular philosophical school to education — that prevailed through the mid‐twentieth century; to the wide‐ranging contemporary work in the field that draws from newer methodologies and philosophical research programs.
Constraints on the absorption-dominated model for the X-ray spectrum of MCG–6-30-15
Authors: Reynolds C. S. , Fabian A. C. , Brenneman L. W. , Miniutti G. , Uttley P. , Gallo L. C.
Published: May 2009

Complexities in the X-ray spectrum of the nearby Seyfert 1.2 galaxy MCG–6-30-15 are commonly interpreted in terms of a broad iron line and the associated Compton reflection hump from the innermost relativistic regions of an accretion disc around a rapidly spinning black hole. However, an alternative model has recently been proposed in which these spectral features are caused entirely by complex (ionized and partial-covering) absorption. By considering the fluorescent emission that must accompany photoelectric absorption, we show that the absorption-dominated model overpredicts the 6.4 keV iron line flux unless the marginally Compton-thick absorber responsible for the hard X-ray hump satisfies very restrictive geometric constraints. In the absence of a specific model that both obeys these geometrical constraints and is physically plausible, the relativistic-reflection model is favoured.
From the Inside Looking out and the Outside Looking in: Whatever Happened to ‘Behavioural Geography’?
Authors: ARGENT N.M. , WALMSLEY D.J.
Published: May 2009

As part of the Institute of Australian Geographers' Millennium Project, this article examines the shift of behavioural geography from a cutting edge sub‐discipline to a branch of enquiry that is now much less prominent in mainstream human geography, especially in Australia. Through an exploration of the rationale for behavioural geography, a brief outline of the nature of the work that was done, and a consideration of the critiques of behavioural geography, the paper argues that behavioural geography enriched the discipline in several ways: it was instrumental in encouraging geographers to consider the epistemological foundations of the discipline; it fostered consideration of a variety of philosophical and methodological positions; and it highlighted the need to consider interrelationships between individuals, groups, society and environment thereby bringing into prominence the ways in which shared environmental meanings are contested and negotiated. Behavioural geography might be a term that is used much less than it once was and behaviourally‐orientated research might increasingly find expression in interdisciplinary outlets rather than in mainstream geography journals but contemporary geography is heir to the endeavours of behavioural geography.
Non‐surgical management of paraesthesia and pain associated with endodontic sealer extrusion into the mandibular canal
Authors: Froes Fabiana Gama Benevides , Miranda Águida Maria Menezes Aguiar , Abad Ernani da Costa , Riche Fernanda Nehme , Pires Fábio Ramôa
Published: May 2009

The aim of this report was to present a case of endodontic sealer extrusion into the mandibular canal in a 42‐year‐old woman. The patient was referred to the Endodontology and Stomatology Clinics, School of Dentistry, Estácio de Sá University, complaining of 5‐day duration intense spontaneous pain and paraesthesia, both arising after an endodontic intervention. Conventional radiographs and computed tomography of the mandible showed the presence of radiopacities inside the right mandibular canal. History and these radiographs confirmed extrusion of endodontic sealer. Treatment included an anti‐inflammatory drug, completion of endodontic treatment and follow up. The patient reported gradual improvement, becoming asymptomatic after 2 months. Radiographs 30 months after initial examination revealed partial resorption of the foreign material. In conclusion, iatrogenic extrusion of endodontic materials should be included in differential diagnosis of endodontic pain and can sometimes be managed through non‐surgical interventions in some cases.
Antimicrobial substantivity of root canal irrigants and medicaments: A review
Authors: Mohammadi Zahed , Abbott Paul V.
Published: May 2009

Disinfection of the root canal system is one of the primary aims of root canal treatment. This can be achieved through the use of various antimicrobial agents in the form of irrigants and medicaments. These agents are only used for relatively short periods of time ranging from minutes (for irrigants) up to days or several weeks (for medicaments) and therefore their long‐term antimicrobial effects rely on whether or not the particular agent has any properties of substantivity. If irrigants and medicaments had effective long‐term residual antimicrobial activity that could prevent re‐infection of the root canal system, then the long‐term outcomes of endodontic treatment might be improved. Only a small number of studies have investigated the short‐term substantivity of commonly used antimicrobial agents and the results show substantivity of chlorhexidine lasts for up to 12 weeks and tetracycline for up to 4 weeks. However, it is not known whether the substantivity of these agents will last for longer periods of time as this has not been investigated.
An evidence‐based approach to the child who drools saliva
Authors: Little S.A. , Kubba H. , Hussain S.S.M.
Published: May 2009

Background:  Drooling is a common dysfunction in children with cerebral palsy and may also affect neurologically unimpaired children. It causes significant social handicap to both children and their families.

Methods:  The data in this article are supported by a Medline search (November 2008) utilising the keywords drooling, sialorrhea, botulinium toxin, salivary duct ligation and also by the use of the personal bibliographies of the senior authors.

Results:  The majority of the published literature for drooling is of level III/IV evidence.

Conclusion:  Multiple therapeutic interventions are available for paediatric drooling. These are most appropriately introduced in a stepwise progression from behaviour therapy, to pharmacotherapy to surgical procedures.
Results of primary ossiculoplasty in ears with an intact stapes superstructure and malleus handle: inflammation in the middle ear at the time of surgery does not affect hearing outcomes
Authors: Martin T.P.C. , Weller M.D. , Kim D.S. , Smith M.C.F.
Published: May 2009

Objective:  To determine whether any factors are predictive of success or failure in primary ossiculoplasty employing autologous bone in Austin‐Kartush Group A (stapes and malleus handle present) ears.

Study design:  Retrospective review of a single‐surgeon case series.

Setting:  Two District General Hospitals in the United Kingdom.

Patients:  Of 135 patients undergoing primary repair, 116 had sufficient data for analysis (mean follow‐up 33 months).

Main outcomes measured:  Postoperative air–bone gaps (pABG) in patients with differing qualities of middle‐ear mucosa (active versus inactive), differing pathologies (mucosal versus squamous) and differing surgical procedures [canal‐wall up (CWU) versus canal‐wall down (CWD)].

Secondary outcome measure:  ‘Belfast Rule of Thumb’ (operated ear hearing brought to 30 dB or better or to within 15 dB of contralateral ear).

Results:  Postoperative ABGs were closed within 10 dB in 37%, 20 dB in 74% at latest follow‐up. The only significant factors predicting hearing outcomes were the status of the canal wall (CWU = 14.1 dB, CWD = 24.7 dB: significant, P = 0.00) and whether surgery was primary or revision. Mean ABG was 14.7 for inactive middle ear mucosa, 17.2 for active middle ear mucosa (not significant, P = 0.25). Excluding CWD procedures from the analysis improved outcomes to 80% (within 20 dB) and 41% (within 10 dB) overall, and the mean for active and inactive ears to 14.2 and 14.0 dB respectively. Postoperatively, 82% of patients fulfilled the ‘Belfast Rule of Thumb’.

Conclusion:  The most significant prognostic factor affecting hearing outcomes – status of the canal wall – is independent of staging. The factor most associated with staging – the status of the middle ear mucosa – is only weakly associated with a successful functional outcome.
Home range and seasonality of Yunnan snub‐nosed monkeys
Authors: REN Baoping , LI Ming , LONG Yongcheng , WU Ruidong , WEI Fuwen
Published: May 2009

Home range studies are essential for understanding an animal's behavioral ecology and for making wildlife conservation efficient. The home range of a group of Yunnan snub‐nosed monkeys (Rhinopithecus bieti Milne‐Edwards, 1897) was estimated using a global positioning system collar from December 2003 to October 2004 in northern Yunnan Province, China. To measure the ranging area of the study group 1291 animal locations were fixed. Based on the 100% minimum convex polygon method, the home range size was approximately 32.8 km2; based on the grid‐cell method it was approximately 17.8 km2 using a 250‐m grid and 23.3 km2 using a 500‐m grid. We assessed seasonal changes in the home range of this monkey population and found a different ranging pattern of from earlier studies. Daily range size was calculated as 4.80 ± 5.81 ha (mean ± standard deviation), with arange of 45.66 ha (0.01–45.67 ha).
The Tight Junction Protein ZO‐2 Blocks Cell Cycle Progression and Inhibits Cyclin D1 Expression
Authors: Gonzalez‐Mariscal Lorenza , Tapia Rocio , Huerta Miriam , Lopez‐Bayghen Esther
Published: May 2009

ZO‐2 is an adaptor protein of the tight junction that belongs to the MAGUK protein family. ZO‐2 is a dual localization protein that in sparse cultures is present at the cell borders and the nuclei, whereas in confluent cultures it is concentrated at the cell boundaries. Here we have studied whether ZO‐2 is able to regulate the expression of cyclin D1 (CD1) and cell proliferation. We have demonstrated that ZO‐2 negatively regulates CD1 transcription by interacting with c‐Myc at an E box present in CD1 promoter. We have further found that ZO‐2 transfection into epithelial MDCK cells triggers a diminished expression of CD1 protein and decreases the rate of cell proliferation in a wound‐healing assay.
Control of the Blood–Brain Barrier by Glucocorticoids and the Cells of the Neurovascular Unit
Authors: Kröll Susanne , El‐Gindi Jehad , Thanabalasundaram Gokulan , Panpumthong Patcharee , Schrot Sebastian , Hartmann Christoph , Galla Hans‐Joachim
Published: May 2009

The blood–brain barrier is built up by endothelial cells lining the cerebral capillaries whereby the physical diffusion barrier is formed by tight junctions sealing the intercellular clefts. Chemical factors being released endogenously to the blood stream may regulate the barrier tightness. However, since tight junctions of the cerebral capillaries are more complex compared to those of other vessels, it becomes evident that the cells of the neurovascular unit play an important role in the induction and the maintenance of the barrier properties. Astrocytes and pericytes interact with the endothelial cells whereby the contact zone is built up by the extracellular matrix. Thus, in addition to chemical mediators released from either cells of the cerebrovascular unit leading to a crosstalk between those cells, the presence of given molecules of the extracellular matrix and also their assembly have to be considered in the transfer of signals able to induce or modulate the barrier. Here we report and summarize recent evidence that external factors like glucocorticoids act in concert with astroyctes in a co‐culture system of primary porcine endothelial cells with astrocytes, but only if astrocytes are able to contact the endothelial cells. Moreover, evidence will be given to show that astrocytic and also the pericytic extracellular matrix produced by those cells are able to induce the barrier by an upregulation of the tight junction proteins occludin, claudin‐5 and ZO‐1, both on mRNA and at the protein level.
Insights into Driving Forces and Paracellular Permeability from Claudin‐16 Knockdown Mouse
Authors: Shan Qixian , Himmerkus Nina , Hou Jianghui , Goodenough Daniel A. , Bleich Markus
Published: May 2009

Tight junction (TJ) properties are determined by membrane protein complexes of neighboring cells that form both a barrier and a selective pathway for paracellular substrate transport. Our previous work supports the view that paracellular permeability changes in the thick ascending limb (TAL) may underlie the mechanism for familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC), a rare autosomal recessive disease linked to mutations in claudin‐16 (CLDN16) and claudin‐19 (CLDN19). CLDN16 knockdown (KD) mice are lacking CLDN16 expression by transgenic RNA interference. We observed that the transport defect for Mg2+ and Ca2+ in this animal model is caused by a loss of paracellular cation selectivity. The permeability ratio for Na+ over Cl− in KD mice was lower by a factor of two without a change in paracellular conductance, compared to wild type (WT). This resulted in a collapse of the transepithelial voltage, which is the driving force for Mg2+ and Ca2+ absorption in TAL. Since CLDN16 KD mice revealed lower blood pressure and an increased aldosterone plasma concentration, we hypothesize that the reduction in paracellular selectivity could allow backflow of Na+ and Cl− into the lumen of the TAL, thus enhancing the distal NaCl load and challenging the organism with a latent NaCl loss.
The Role of JAM‐A in Inflammatory Bowel Disease: Unrevealing the Ties That Bind
Authors: Vetrano Stefania , Danese Silvio
Published: May 2009

Tight junctions (TJ) are junctional proteins whose function is to maintain an intact intestinal epithelial barrier and regulate the paracellular movement of water and solutes. Altered TJ structure and epithelial permeability are observed in inflammatory bowel disease and seem to have an important role in the pathogenesis of these diseases. Junctional adhesion molecule‐A (JAM‐A) is a protein expressed at tight junctions of epithelial and endothelial cells, as well as on circulating leukocytes. Its function at tight junctions appears to be crucial as an extracellular adhesive molecule in the direct regulation of intestinal barrier function. This review focuses on the role of JAM‐A in controlling mucosal homeostasis by regulating the integrity and permeability of epithelial barrier function.
High‐Resolution Analysis of Barrier Function
Authors: Fromm Michael , Krug Susanne M. , Zeissig Sebastian , Richter Jan F. , Rosenthal Rita , Schulzke Jörg‐Dieter , Günzel Dorothee
Published: May 2009

High‐resolution analysis of epithelial barrier function adds substantial information to that provided by conventional transepithelial electrical resistance (TER) measurements. This chapter describes three high‐resolution techniques. First, two variants of impedance spectroscopy are delineated. One‐path impedance spectroscopy discriminates vertically between serial pathways, namely resistances of the epithelial cell layer and of subepithelial tissues. As a typical application, measurements on human sigmoid colon biopsies from patients suffering from Crohn's disease are reported. Two‐path impedance spectroscopy allows to discriminate between trans‐ and paracellular resistance, and the general principle of this technique is outlined. Second, the conductance scanning technique is presented, which discriminates horizontally between optically distinct parallel pathways over a wide range of spatial resolutions. Using this technique, it was shown that occludin – in contrast to the then prevailing opinion – is not irreplaceable to barrier function. Third, three‐dimensional confocal fluorescence imaging for depicting transepithelial transport processes is introduced. Using this method the transepithelial translocation of bacteria which generate focal leaks was discovered.
Roles of ZO‐1 and ZO‐2 in Establishment of the Belt‐like Adherens and Tight Junctions with Paracellular Permselective Barrier Function
Authors: Tsukita Sachiko , Katsuno Tatsuya , Yamazaki Yuji , Umeda Kazuaki , Tamura Atsushi , Tsukita Shoichiro
Published: May 2009

Tight junctions (TJs) create the primary permselective barrier to diffusion of solutes and ions through the paracellular pathway. The molecular architecture of TJs has gradually been unraveled in recent years, providing the basis for “barriology” (defined by Shoichiro Tsukita as the science of the barrier in multicellular organisms). Claudins are now considered to be the essential basic components of TJ strands, with which other integral membrane proteins, such as occludin, tricellulin, JAMs, and CAR, are associated. Peripherally associated scaffolding proteins are required for the organization of the integral membrane proteins. Among these, ZO‐1, ‐2, and ‐3 have attracted a great deal of attention as TJ organizers, since ZO‐1 (and in some cases, also ZO‐2/3) was reported to be directly associated with claudins, occludin, and JAMs, as well as with AF‐6/afadin and alpha‐catenin. Here we summarize recent studies on ZO‐1/2/3‐deficiency in mice and cells, which have provided clear and important information regarding the functions of ZO‐1/2/3 in vivo. In addition to the respective suppression of ZO‐1/2/3 expression, simultaneous suppression of all three proteins has revealed the essential and nonessential in vivo roles of ZO‐1/2 and ZO‐3, respectively. ZO‐3 shows an epithelial‐specific TJ localization in a ZO‐1/2–dependent fashion. ZO‐1 and ZO‐2 play pivotal roles in the final establishment of the belt‐like adherens junctions (zonula adherens), followed by the formation of the belt‐like TJs (zonula occludens) with paracellular barrier function, thereby providing the general basis for selective paracellular permeability in epithelial and endothelial cells.
Epithelial Tight Junctions in Intestinal Inflammation
Authors: Schulzke Joerg D. , Ploeger Svenja , Amasheh Maren , Fromm Anja , Zeissig Sebastian , Troeger Hanno , Richter Jan , Bojarski Christian , Schumann Michael , Fromm Michael
Published: May 2009

The epithelium in inflamed intestinal segments of patients with Crohn's disease is characterized by a reduction of tight junction strands, strand breaks, and alterations of tight junction protein content and composition. In ulcerative colitis, epithelial leaks appear early due to micro‐erosions resulting from upregulated epithelial apoptosis and in addition to a prominent increase of claudin‐2. Th1‐cytokine effects by interferon‐γ in combination with TNFα are important for epithelial damage in Crohn's disease, while interleukin‐13 (IL‐13) is the key effector cytokine in ulcerative colitis stimulating apoptosis and upregulation of claudin‐2 expression. Focal lesions caused by apoptotic epithelial cells contribute to barrier disturbance in IBD by their own conductivity and by confluence toward apoptotic foci or erosions. Another type of intestinal barrier defect can arise from α‐hemolysin harboringE. colistrains among the physiological flora, which can gain pathologic relevance in combination with proinflammatory cytokines under inflammatory conditions. On the other hand, intestinal barrier impairment can also result from transcellular antigen translocation via an initial endocytotic uptake into early endosomes, and this is intensified by proinflammatory cytokines as interferon‐γ and may thus play a relevant role in the onset of IBD. Taken together, barrier defects contribute to diarrhea by a leak flux mechanism (e.g., in IBD) and can cause mucosal inflammation by luminal antigen uptake. Immune regulation of epithelial functions by cytokines may cause barrier dysfunction not only by tight junction impairments but also by apoptotic leaks, transcytotic mechanisms, and mucosal gross lesions.
Intracellular Life of Coxiella burnetii in Macrophages
Authors: Ghigo Eric , Pretat Lionel , Desnues Benoît , Capo Christian , Raoult Didier , Mege Jean‐Louis
Published: May 2009

Coxiella burnetii, the agent of Q fever, is an obligate intracellular bacterium that is considered a potential biological weapon of category B. C. burnetii survives within myeloid cells by subverting receptor‐mediated phagocytosis and preventing phagosome maturation. The intracellular fate of C. burnetii also depends on the functional state of myeloid cells. This review describes the mechanisms used by C. burnetii to circumvent uptake and trafficking events, and the role of cytokines on C. burnetii survival in myeloid cells.
Deciphering the Relationships between Rickettsia conorii conorii and Rhipicephalus sanguineus in the Ecology and Epidemiology of Mediterranean Spotted Fever
Authors: Parola Philippe , Socolovschi Cristina , Raoult Didier
Published: May 2009

Mediterranean spotted fever is the most important tick‐borne disease occurring in Southern Europe and North Africa. The first case of this life‐threatening zoonosis was reported in 1910. In the 1930s, the role of the brown dog tick, Rhipicephalus sanguineus, and the causative agent, Rickettsia conorii were described. However, basic questions regarding the relationships between the rickettsia and its tick vector are still unresolved, and the life cycle of R. conorii is incompletely known. There is a lack of knowledge associated with the role of Rh. sanguineus in the maintenance and transmission of R. conorii. The infectious rate of Rh. sanguineus ticks with R. conorii has been found low every time it has been tested; usually lower that 1%. The deleterious impact of R. conorii on ticks has been suggested in experimental models as a potential reason to explain a low prevalence in nature. The long‐recognized phenomenon known as reactivation has been suggested as a cause of negative effects – that is, the change in temperature and physiology of the tick host induces the agent to emerge from dormancy and attain infectivity with bad effects on ticks. However, naturally infected colonies of ticks have been maintained in laboratory conditions over several generations. We discuss here several aspects that have been recently studied to better understand Rh. sanguineus–R. conorii relationships, including comparison between the fitness of infected and non‐infected ticks in laboratory conditions and the role of external factors such as temperature and starvation.
Current Knowledge on Phylogeny and Taxonomy of Rickettsia spp.
Authors: Fournier Pierre‐Edouard , Raoult Didier
Published: May 2009

Due to improved diagnostic methods and increased interest, the number of representatives of the genus Rickettsia has increased dramatically over the past 20 years, with 25 currently validated species. These arthropod‐associated intracellular bacteria are now recognized in all parts of the world. The comparison of the phylogenic organizations obtained from the study of several genes with different functions, and more recently from genomic sequences, provided basis to establish a reliable taxonomy of the bacteria induded in the genus Rickettsia. These data were incorporated into polyphasic consensus guidelines that provide clear recommendations for the taxonomic classification and nomenclature of rickettsiae and rickettsial diseases.
Globalization, the Welfare State and Young People Leaving State Out‐of‐Home Care
Authors: Mendes Philip
Published: May 2009

Some theories of globalization argue that it is producing a uniform reduction in social spending, while others claim that global influences are mediated by specific national factors. This article argues that the emergence of support for young people leaving state out‐of‐home care in almost all developed countries provides further evidence for the mediation thesis. Using Australia as a case study, attention is drawn to the commonality of poor outcomes for many care leavers, the different legislative and policy responses to these needs in a range of welfare states, and the role played by local and global researchers and policy advocates in bringing these needs to public and political attention.
‘Beauty Will Save the World’: Beauty Discourse and the Imposition of Gender Hierarchies in the Post‐War Chechen Republic
Authors: Banner Francine
Published: May 2009

This paper utilises the case study of the recent Miss Chechen Beauty pageant in order to discuss the ways in which gendered discourses and practices have affected the situation of women in the post‐war Chechen Republic. Although, on the surface, they appear to have little in common, the paper draws on connections between women's bodies and nation‐states in order examine practices such as beauty pageants, honor killings, and government‐enforced modesty campaigns that are currently taking place in the republic. Ultimately, the paper argues that beauty contests and modesty campaigns share in common the fact that they are being utilised by the state to relegate women to private spaces and to re‐enforce gender hierarchies in the aftermath of two brutal conflicts.
EFFECT OF VISION ON DEVELOPMENT OF MULTIPLY HANDICAPPED CHILDREN
Authors: VAN DIJK JAN
Published: May 2009

The effect of vision on (abnormal) development was studied in a group of 81 visually and/or hearing impaired rubella children, 18 of whom had bi‐lateral cataracts operated between 2–18 months, 3 children had uni‐lateral cataract, and 60 children had clear media. In this group of children the effect of visual impairment on (abnormal) behaviour is enormous. Vision has in these children a greater impact on their development than hearing impairment or prenatal variables such as low birthweigt. This justifies the conclusion of cataract surgery as early as possible. After surgery the environment should be manipulated in such a way, that it becomes visually attractive for the child. This might prevent strong light‐gazing and/or exhibiting the phenomenon of HBE (Hand Before the Eyes). The desire for rocking and jumping should be seen in connection with stimulus deprivation, especially social ones. It is therefore recommended that these childrens should be offered ample experience and interaction with the environment, such as giving the child proprioceptive stimuli, rocking him in the crib or on the lap. The interest in the world outside his own body should be encouraged by manipulating the children's special interest (such as changing the objects for light gazing). The purpose for this kind of management is to develop orientation reflex, in other words to stimulate the child to give attention to the world around him and therefore learn from it. When this sort of early stimulation is provided the child̂s development may be not so retarded as without appropriate intervention.
ONE HUNDRED AND TWENTY VISUALLY HANDICAPPED CHILDREN BELOW 7 YEARS OF AGE
Authors: RUUD EGIL
Published: May 2009

120 visually handicapped pre‐school children are evaluated according to eye disease and its etiology, and the associated handicap, all related to the different levels of functioning. One third of the children fulfil the expectations on visually handicapped children. The group consists mainly of children suffering from hereditary ocular disorders and some children with retrolental fibroplasia. One third of the children are moderately or severely intellectually impaired, bearing a heavy burden of additional handicaps; many are born premature or dysmature, having suffered perinatal complications. The final third are children who fall outside the other 2 groups, some with a brain damage syndrome, some with light or moderate behavioural and emotional disturbance. The moderate and severe emotional disturbance and its relation to a brain dysfunctional syndrome are discussed.
HLA SYSTEM AND MYASTHENIA GRAVIS
Authors: SAARI K. M.
Published: May 2009

In Caucasians myasthenia gravis (MG) showed a strong assosiation with HLA‐BS and a secondary association with HLA‐A1, Dw3 and DR3. Female MG patients had a higher frequency of HLA‐B8 than males and the presence of HLA‐B8 was correlated with early onset of the disease. In Japanese there was a strong association of MG with HLA‐B12 and a less strong association with HLA‐A9 and HLA‐Bw35.
DIABETES MELLITUS AND DIABETIC RETINOPATHY
Authors: SAARI K. M.
Published: May 2009

HLA studies showed that there is an increased relative risk of developing insulin‐dependent diabetes mellitus, irrespective of age of onset, in subjects who are HLA‐Dw3 or HLA‐DR3 positive, with secondary associations with A1, B8 or B18, and in subjects who are Dw4 or DR4 positive, with secondary associations with A2, B15, B40 and Cw3. Subjects who are HLA‐Dw2 or HLA‐DR2 positive, with secondary association with A3 and B7, have a significantly reduced risk of developing the disease. No association has been confirmed in independent studies between HLA and noninsulin‐dependent diabetes mellitus. There is no confirmed evidence that HLA would be involved in the susceptibility to retinopathy once diabetes has developed.
HLA AND DISEASE ASSOCIATIONS
Authors: OHNO SHIGEAKI
Published: May 2009

It remains unknown what mechanisms underlie the association between the HLA system and susceptibility to certain ocular diseases. Genetic mechanism, as well as the biological mechanism may explain some of associations. It is obvious that various diseases cannot be expected to fit one model. Further studies of the true biological function of HLA gene products may elucidate the pathogenesis of various diseases.
GLARE FROM OUTDOOR HIGH MAST LIGHTING: EFFECTS ON VISUAL ACUITY AND CONTRAST SENSITIVITY IN COMPARATIVE STUDIES OF DIFFERENT FLOODLIGHTING SYSTEMS
Authors: CARLSSON LARS , KNAVE BENGT , LENNERSTRAND GUNNAR , WIBOM ROGER
Published: May 2009

Glare effects on visual acuity and contrast sensitivity were studied at outdoor timber terminal work with conventional far‐reaching floodlighting and with a new type of oblique floodlighting with an asymmetrical light distribution. The binocular work visual acuity of 19 volunteers was measured at 40, 55 and 80 per cent contrast and the contrast sensitivity of 14 volunteers at spatial frequencies of 0.5, 1, 2, 4, 8 and 16 cycles/degree. With the light source 15 degrees from the centre of the visual fields the visual acuity as well as the contrast sensitivity was consistently lower with the conventional type than the new type of floodlight. The results thus indicate that not only the vision of details is impaired by glare but also the contrast perception of sparse patterns. In standardized rating scales the timber terminal workers scored the difference in glare between the two floodlight systems as »great»—»very great».
SUCCESSFUL INTRAOCULAR LENS IMPLANTATION: A HISTOLOGICAL AND SCANNING ELECTRON MICROSCOPIC STUDY OF FOUR CASES
Authors: Mullaney J. , Lucas D. R. , Condon P. I.
Published: May 2009

Abstract. The histological findings in four globes obtained at autopsy from clinically uncomplicated cases with intraocular lens implants, one glass posterior chamber and three anterior chamber lenses consisting of two pupillary fixated and one »in‐the‐bag» fixated Binkhorst lens, are reported. Minimal changes could be detected in the tissues with which the implants were in contact.

Scanning electron microscopy of the cornea in the three anterior chamber implants showed a loss of endothelial cells in the axial region of roughly 30–50%. There was marked vertical disparity in the loss.

Scanning microscopy of the implants showed evidence of surface degradation of the nylon loops of all the anterior chamber implants.
The effect of ocular pigmentation on intraocular pressure responce to timolol
Authors: Salminen Lotta , Imre György , Huupponen Risto
Published: May 2009

Abstract The one‐hour intraocular pressure (IOP) response to topical ocularly applied timolol was studied in darkly and lightly pigmented eyes. One drop of 0.25% 1‐timolol was applied to one eye of ten subjects with brown and ten subjects with blue iris color. In the treated and untreated eyes with blue iris color the IOP fell significantly from the baseline value, whereas no pressure reduction was obtained either in the treated or untreated eyes with brown iris color. Beta‐blocking agents are known to accumulate in pigment‐containing ocular structures. The lack of a one‐hour pressure response to timolol in darkly pigmented eyes observed in our study may refer to the reduction of 1‐timolol in the biophase due to excessive pigment binding.
Juvenile vitreoretinal degeneration and retinal detachment
Authors: Saari K. M.
Published: May 2009

Abstract The proband was a 10‐year‐old boy with bilateral retinal detachment. His mother had unilateral retinal detachment at age of 12. The eye disease occurred in eight family members, both men and women, in four consecutive generations suggesting autosomal dominant inheritance. The eye findings were seen at the age of 4 to 12 and included syneresis and posterior vitreous detachment; spotty areas of whitish, glistening degeneration, spotty hyperpigmentation, and greyish‐white patches with pigmentations suggestive of healed retinochoroiditis in the peripheral retina. Retinal detachment with holes in the peripheral retina occurred in four family members, and three other family members had unilateral blindness since early childhood. In eyes without retinal detachment the visual acuity, visual fields, dark adaptation, and colour vision were normal.