bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of conjunctival morphology in thyroid associated eye disease by use of impression cytology
Authors: Özkan Seyhan B. , Söylev Meltem F. , Vahapoĝlu Haldun , Can Deniz , Arsan Aysu K. , Duman Sunay
Published: May 2009

ABSTRACT Thirty‐one patients with the diagnosis of thyroid associated eye disease were included in the study. Samples were obtained from upper and temporal bulbar conjunctiva of both eyes by cellulose acetate filter paper. Control group included 20 healthy individuals. In patients with thyroid associated eye disease, grade 2 or 3 squamous metaplasia was observed in 32.26% of the samples obtained from upper bulbar conjunctiva, whereas this ratio increased to 82.26% in temporal bulbar area. None of the control cases showed changes of grade 2 or more. The evaluation of cytological changes with respect to clinical findings revealed that the main factor responsible for the cytological findings was inflammatory changes of the conjunctiva, whereas interpalpebral distance and proptosis had only a partial effect.
Tumour cell proliferation after failed ruthenium plaque radiotherapy for posterior uveal melanoma
Authors: Seregard Stefan , Lundell Göran , Lax Ingmar , af Trampe Eva , Kock Erik
Published: May 2009

ABSTRACT Enucleation following ruthenium plaque radiotherapy for posterior uveal melanoma indicates failure of treatment. This study focused on the histopathological findings and remaining tumour cell growth fraction in 42 of 46 patients with failed ruthenium plaque treatment (of 266 patients treated) for melanoma of the choroid or ciliary body. The cause for enucleation was clinically detected tumour regrowth in 27 (64%) patients, treatment‐related ocular side effects in 12 (29%) cases and the patient's personal preference in three (7%) cases. The median time elapsing from plaque radiotherapy to enucleation was not significantly different for patients with recurrent tumour growth (23 months) compared to those enucleated without clinical signs of regrowth (19 months). While all tumours showed some regressive features by histopathological examination, only five melanomas were completely necrotic and viable‐appearing tumours cells were present in all of the remaining 37 (88%) irradiated tumours. Microwave processed PC‐10 immunostainings increased the sensitivity to detect cycling cells compared to the sole use of mitotic cell counts. By the former technique, proliferating tumour cells were detected in 17 of 23 (74%) studied melanomas of eyes enucleated for tumour regrowth following brachytherapy. Also, the number of cycling melanoma cells was similar to that of non‐irradiated controls managed solely by enucleation. In contrast, the proliferative compartments of irradiated, but non‐recurrent, posterior uveal melanomas were significantly reduced compared to those of matched controls. Still, cycling tumour cells were present in four of 13 (31%) irradiated melanomas, clinically assumed to be successfully treated.
Effects of viscoelastics on bovine corneal endothelial cells in vitro
Authors: Zhu Su‐Ning , Nölle Bernhard , Duncker Gernot
Published: May 2009

ABSTRACT Purpose: To evaluate the possible toxic effects of sodium hyaluronate and hydroxypropyl methylcellulose on corneal endothelium.

Methods: Cultured bovine corneal endothelial cells (BCEC) were treated with either original Healon® (10 mg/ml) or Methocel® (20 mg/ml) for 1 h, or with various dilutions of these substances in culture medium for up to one week. The toxicity of the viscoelastics was assessed in terms of lactate dehydrogenase (LDH) release into the supernatant and of cell density.

Results: Neither Healon nor Methocel in a dilution of 2 mg/ml enhanced LDH release after 72 h incubation, when compared with the control in a confluent model. In a proliferation model neither diluted Healon nor Methocel showed apparent inhibitory or stimulatory effects on the growth of BCEC up to the highest concentration we tested. When a BCEC monolayer was covered for 1 h with either undiluted Healon or undiluted Methocel, a significant, though transient, higher LDH release was induced.

Conclusion: The results indicate that the diluted viscoelastics are safe for long time contact with BCEC, but undiluted they may temporarily interfere with the metabolism of the cytoplasm membranes of BCEC.
Accuracy of IOL calculation in cataract surgery
Authors: Brandser Rønnaug , Haaskjold Erling , Drolsum Liv
Published: May 2009

ABSTRACT The accuracy of IOL calculation using the SRK II formula was studied in 515 cataract extractions with posterior chamber IOLs. All excessively myopic patients (8 patients) and those where we had predicted an emmetropic postoperative result, from a consecutive series of 994 patients, were included. Preoperatively the patients were divided into different groups according to their refractive status and the mean postoperative refraction was calculated in each group. The mean postoperative refraction increased almost linearly with increasing myopic status. The emmetropic group achieved a mean postoperative refraction of ‐0.6 D, whilst in the most myopic group mean refraction was ‐1.8 D. We believe that the SRK II formula is inaccurate for myopic eyes, and that new formulas are needed, taking into account all those factors that make up the dioptric power of an eye.
Perimetric probability maps to separate change caused by glaucoma from that caused by cataract
Authors: Bengtsson Boel , Lindgren Anna , Heijl Anders , Lindgren Georg , Åsman Peter , Patella Michael
Published: May 2009

ABSTRACT We describe a new method for analysis of change in glaucomatous visual fields with the object to differentiate between changes caused by glaucoma from those caused by cataract. New pattern deviation change probability maps were developed from a prospectively collected glaucoma material and designed to be sensitive to changes in localized field loss, but to be unaffected by media‐induced perimetric change. We compared the new change probability maps with the commercially available total deviation change probability maps in series of Humphrey perimetric tests in a glaucoma material of 43 eyes of 35 patients, who had undergone cataract surgery. When using the total deviation maps, considerable differences were seen between fields obtained before and after cataract surgery. Much smaller differences were seen when using the new change probability maps, that almost eliminated the common and disturbing effect of increasing cataract. This new tool could be of considerable help in differentiation between progressive glaucomatous visual field loss and deterioration caused by increasing media opacities.
The effect of heparin‐surface‐modification on scar‐tissue formation around a subconjunctival polymethylmethacrylate implant in the rabbit
Authors: Kivalo Matti
Published: May 2009

ABSTRACT Purpose: Excessive scar tissue formation around ocular drainage implants is a common cause for implant failure. The purpose of this study was to evaluate the effect of heparin‐surface‐modification of a subconjunctival polymethylmethacrylate implant on scar‐tissue formation in the rabbit eye.

Methods: Plain and heparin‐surface‐modified polymethylmethacrylate implants were implanted subconjunctivally in the eyes of 13 rabbits in two groups consisting of 8 and 5 animals. In the latter group the implants were in contact with aqueous humour through a fistula into the anterior chamber.

Results: Both unmodified and heparin‐surface‐modified polymethylmethacrylate implants were well tolerated. In histological sections studied by both light microscopy and transmission electron microscopy, heparin‐surface‐modification of polymethylmethacrylate implants seemed to diminish the formation of scar tissue around the subconjunctival implants.

Conclusion: Heparin‐surface‐modification of polymethylmethacrylate implants could provide one way to affect the formation of excessive fibrous tissue around ocular drainage implants.
Visual impairment in Swedish children
Authors: Blohmé Jonas , Tornqvist Kristina
Published: May 2009

ABSTRACT The analysis of etiological factors in a group of visually impaired children is of considerable importance when trying to find guidelines for possible preventive work. In this study we present etiological data on 2373 Swedish children. Data have been obtained by reviewing medical records on all known children with visual impairment throughout the country. In accordance with similar studies from industrialised countries, the group with prenatal etiology was the predominant, comprising 64% of the material. Within this group, half the patients had a disease of genetic origin. A total of 50% of all patients with prenatal etiology had an additional impairment, but in the group with diseases of genetic origin this proportion was smaller, only 40%. On the other hand, many children with additional impairments were found among those with an unspecified prenatal influence. Peri‐/neonatal etiologies were found in 20% of the patients. In this group as many as 83% had additional impairments. This was even more pronounced among children delivered at term. The group with infantile/juvenile etiologies was small, 7%, with additional impairments in 66%. In 9% of all patients the etiology was classified as unknown. Among these, 80% had additional impairments. The visual impairment tended to be more pronounced, the later the disease was acquired. A male preponderance was seen in most etiological subgroups and in the material as a whole.
Prevalence of congenital colour blindness among Inuit in East Greenland
Authors: Norn Mogens
Published: May 2009

ABSTRACT Purpose: To establish whether congenital colour blindness among males is still rare in Inuit (Eskimos) as indicated previously in 1893 and 1930, especially in East Greenland, as demonstrated by Erik Skeller in 1950.

Mehods: The study was comprised mainly of school children. 540 Inuit in East Greenland were compared to 545 controls in East Greenland and Denmark examined by three sets of pseudoisochromatic plates (Ishihara 1932, original plate used by Skeller), Ishihara (1994), and standard P.P. 2 part Igaku‐Shoin (1994).

Results: Only 1.0% of male Inuit (3/290) are colour blind, a significantly lower incidence than the 8.7% among Danish males in Denmark (15/173). The prevalence was the same in the three control groups, Danes in East Greenland, immigrants and Danes in Denmark. Deuteranopia is the most common type. Females showed the same low prevalence in all four groups.

Major conclusions: Colour blindness is still remarkably low among Inuit in East Greenland as compared with the present three control groups.
Practice styles and preferences of Danish cataract surgeons – 1996 survey
Authors: Hansen Tom Eggert
Published: May 2009

ABSTRACT A survey of the practice styles and preferences of the members of the Danish Ophthalmological Society with address in Denmark was performed in January 1996. Only ophthalmologists performing cataract surgery were asked to return the questionnaire. Eighty‐five responses were received by the cut‐off day, representing 24 948 cataract operations per year. The data were compared to a similar questionnaire analysing the 1995 practice styles and preferences.
Rhegmatogenous retinal detachment operation after radial keratotomy
Authors: Weinberger Dov , Fink‐Cohen Smadar , Axer‐Siegel Ruth
Published: May 2009

ABSTRACT Radial keratotomy has recently been introduced for the correction of myopia. This procedure does not hinder progression of the pathophysiological changes in the myopic eye. We hereby describe a case of rhegmatogenous retinal detachment operation after radial keratotomy and present the operative considerations and refractive results.
Angle closure caused by multiple, bilateral iridociliary cysts
Authors: Tanihara Hidenobu , Akita Joe , Honjo Megumi , Honda Yoshihito
Published: May 2009

ABSTRACT A case of high, broad, peripheral anterior synechiae caused by multiple, bilateral iridociliary cysts is reported. The peripheral anterior synechia in our case extended to the corneal endothelium beyond Schwalbe's line, and iris atrophy in the region of the cysts was found. Ultrasound biomicroscopic imaging showed that multiple, bilateral iridociliary cysts causes elevation of the iris structure.
Autosomal dominant retinitis pigmentosa with a rhodopsin mutation (Arg‐135‐Trp)
Authors: Ponjavic Vesna , Abrahamson Magnus , Andréasson Sten , Ehinger Berndt , Fex Göran
Published: May 2009

ABSTRACT We here present the clinical phenotype in 6 patients from a family with autosomal dominant retinitis pigmentosa found to carry a point mutation in the rhodopsin gene (arginine‐135‐tryptophan). The mutation is the second found by mutation screening of DNA from 20 Swedish families with dominant retinitis pigmentosa. With full‐field electroretinography we could document a severe form of retinitis pigmentosa in patients belonging to the family, similar to the phenotype associated with the previously reported mutation (arginine‐135‐leucine). Our results indicate that different point mutations in the same region of the rhodopsin gene, resulting in amino acids with similar properties (both hydrophobic), may cause a similar clinical phenotype. Further, point mutations in this specific region seem to cause an agressive form of retinitis pigmentosa.
Corrosion casts of the suprachoroidal space and uveoscleral drainage routes in the human eye
Authors: Krohn Jørgen , Bertelsen Torstein
Published: May 2009

Abstract. Human cadaver eyes were studied by corrosion casting technique. Batson's mixture No. 17 (methyl methacrylate) was injected through a sclerotomy into the suprachoroidal space. Following polymerisation of the injected mixture the surrounding tissue was dissolved with 10% natrium hydroxide. Macroscopic and scanning electron microscopic findings in casts of the suprachoroidal space are presented. Due to transscleral drainage of resin from the suprachoroidal space, different types of branches deriving from the outer (scleral) surface of the casts were found. Some of these branches corresponded to the perivascular spaces of both ciliary vessels and vortex veins. In addition, we found branches probably representing channels deriving directly from the suprachoroidal space, communicating with the intrascleral venous plexus. Such channel systems have previously not been described, and their possible relation to the uveoscleral drainage of aqueous humour is discussed.
Incidence and prevalence of different uveitis entities in Finland
Authors: Päivönsalo‐Hietanen Taina , Tuominen Juhani , Vaahtoranta‐Lehtonen Hanna , Saari K. Matti
Published: May 2009

Abstract. We studied the case records of 1122 patients with endogenous uveitis including 418 new cases treated at the University Eye Clinic in Turku during the years 1980–1982 and 1988. The mean annual incidence and prevalence rates (per 100 000 population) of idiopathic acute anterior uveitis were 17.1 and 48.5, respectively, sarcoid anterior uveitis 0.5 and 1.5, Posner‐Schlossman syndrome 0.4 and 1.9, herpes zoster uveitis 0.4 and 0.7, idiopathic chronic anterior uveitis 0.3 and 7.3, herpes simplex keratouveitis 0.3 and 0.5, juvenile rheumatoid arthritis 0.2 and 2.4, Fuchs' heterochromic iridocyclitis 0.2 and 0.5, intermediate uveitis 0.3 and 1.4, and of toxoplasmic retinochoroiditis 0.3 and 2.4. The incidence and prevalence rates of acute anterior uveitis associated with ankylosing spondylitis were 2.0 and 10.3 per 100 000 population, respectively, and this disease association occurred more often in men than in women (p < 0.001). The mean annual incidence of idiopathic acute anterior uveitis was significantly lower in the age group 0–19 years than in the other age groups (p < 0.001).
Diabetic iris neovascularization. Natural history and treatment
Authors: Fernández‐Vigo Jose , Castro Juan , Macarro Ana
Published: May 2009

Abstract. Purpose: To study the spontaneous progression from iris neovascularization to neovascular glaucoma, factors that determine how long it takes and the efficacy of therapy, we studied 81 eyes belonging to 67 diabetic patients.

Methods: The eyes were divided into three groups: control group (29 eyes, 26 patients), photocoagulation group (37 eyes, 30 patients) and cryotherapy group (15 eyes, 11 patients). The controls were observed for at least 12 months, and the treated group over at least the following 3 months.

Results: At the end of the follow‐up period 12 of the 29 control group eyes (41.4%) had developed neovascular glaucoma and 6 (20.5%) increased neovascularization. Seven eyes (58%) that developed glaucoma did so within 3 months. There was no significant difference between the laser therapy (improvement: 84%) and cryotherapy group (80.5%).

Conclusions: At the end of the 12‐month follow‐up period progression from iris neovascularization to neovascular glaucoma is very frequent. There was no difference between laser therapy and cryotherapy.
Safety of β‐adrenergic blocker washout period in clinical trials
Authors: Stroman Gesa A. , Stewart William C. , Stewart Jeanette A. , Deitz Tonya M.
Published: May 2009

Abstract. We prospectively evaluated the safety of the washout period from topical β‐adrenergic blockers prior to clinical drug trials. In 30 consecutive patients optic disc parameters (neural rim, optic disc, peripapillary halo and atrophy areas, and venous/arterial diameters) did not change following washout (p > 0.05). Likewise, the mean defect and pattern standard deviation (Humphrey 30‐2) did not change following washout (p>0.05). This study suggests, generally, the safety of the washout period prior to clinical drug trials.
Cryotherapy in the treatment of cyclodialysis cleft induced hypotony
Authors: Krohn Jørgen
Published: May 2009

Abstract. A 26‐year‐old man with juvenile glaucoma developed persisting hypotonic retinopathy after trabeculotomy ab externo. An unintended cyclodialysis cleft at the site of the trabeculotomy was suspected, but visualization of the chamber angle was impossible due to a shallow anterior chamber. Seven months after the trabeculotomy the patient was treated with transconjunctival cryotherapy at the presumed localization of a cyclodialysis cleft. Eight days later an episode of acute ocular hypertension occurred, otherwise the postoperative course was uneventful with reversal of the hypotony and complete normalization of the visual acuity. The diagnostic and therapeutic problems of a hypotonous cyclodialysis cleft combined with a shallow anterior chamber are discussed.
Retinal white‐centered hemorrhages in infectious mononucleosis
Authors: Törnqvist Göran , Mårtenson Per‐Anders
Published: May 2009

Abstract. White‐centered hemorrhages which are seen rather seldom nowadays are traditionally associated with serious diseases (i.e. septicemia or leukemia). We describe a case of benign infectious mononucleosis with several white‐centered hemorrhages.
Associated ocular findings in pericentral pigmentary retinopathy
Authors: Durlu Yusuf K. , Burumcek Engin , Devranoglu Kazim , Mudun A. Baki , Karacorlu Serra , Arslan M. Okan
Published: May 2009

Abstract. Macular complications occurred in two isolated patients who had pericentral pigmentary retinopathy. One patient demonstrated bilateral bull'seye maculopathy and a unilateral full‐thickness macular hole. Later, she developed central retinal artery occlusion in the fellow eye. The second patient had a rhegmatogenous retinal detachment that was reattached by scleral buckling surgery, but a full‐thickness macular hole was found 3 months postoperatively. In both patients, foveal ischemia may have played a role for the development of macular hole, resulting in poor visual prognosis in pericentral pigmentary retinopathy.
Urticaria in idiopathic bilateral recurrent branch retinal arterial occlusion
Authors: Barak Nir , Ferencz Joseph R. , Freund Michael , Mekori Yoseph
Published: May 2009

Abstract. Idiopathic bilateral recurrent branch retinal arterial occlusion (IBRBRAO) is a rare syndrome characterized by migraine headaches, tinnitus, vertigo, hearing loss, and recurrent branch retinal artery occlusion of unknown etiology. Affected patients frequently undergo a wide range of medical evaluation and have no apparent pathologic findings. We present here a case of IBRBRAO, associated with urticarial rash, not described in this syndrome in previous publications.
Glial cell involvement in vascular occlusion of diabetic retinopathy
Authors: Bek Toke
Published: May 2009

Twenty areas of retinal vascular occlusion from ten eyes of 6 diabetic patients were studied by immunohistochemistry to type IV collagen (basement membranes), von Willebrand factor (endothelial cells), and to glial fibrillary acid protein (glial cells) on serial sections. In all studied lesions immunoreactivity to type IV collagen and von Willebrand factor was confined to the retinal vascular walls whereas the material accumulated to occlude the vascular lumens centrally displayed immunoreactivity to glial fibrillary acid protein. All arterioles observed in the lesions were occluded. These arterioles had retained their circular shape, and the intravascular glial protein immunoreactivity communicated with the extravascular glial tissue through localised breaks in the vascular wall. The intravascular immunoreactivity was found to continue inside the arteriole along its successive diminishing to reach the capillary level. The venules were only occluded in less than half of the studied lesions. These venules were collapsed to assume a bean‐like shape, and sequences with total obliteration of the vascular lumen alternated with sequences where a residual space corresponding to the former lumen displayed immunoreactivity to glial protein. The paper suggests that glial cell invasion, but not endothelial cells or basement membrane thickening, occludes the vascular lumen in areas of retinal non‐perfusion secondary to diabetic retinopathy.
Retinal examination intervals in diabetic patients on diet treatment only
Authors: Hansson‐Lundblad C. , Agardh E. , Agardh C.‐D.
Published: May 2009

Purpose: The aim of the present study was to examine whether type 2 diabetic patients with good metabolic control achieved on diet treatment only, developed sight‐threatening retinopathy during a four‐year follow‐up period.

Methods: A retrospective four‐year follow‐up study was carried out including all diabetic patients on diet treatment only, registered at the out‐patient clinic at the Department of Medicine and referred for fundus photography to the Department of Ophthalmology in 1989 as well as all patients referred from primary care units for fundus photography during 1988 and 1989. One hundred and seventeen diabetic patients treated with diet only were examined with fundus photography after remittance, and after two and four years.

Results: Age at diabetes diagnosis was 58.8 ± 13.8 years (mean ± SD), age at baseline was 61.5 ± 13.6 years, and diabetes duration was 2.7 ± 3.1 years. During the four‐year follow‐up period, 48 of the patients (41%) remained on diet treatment only whereas diabetes treatment was changed in 66 (56%), from diet to oral agents only in 57 (49%), and from diet to insulin alone or in combination with oral agents in 9 (8%) of the patients. One hundred and six patients (91%) did not have any retinopathy at baseline and 11 patients (9%) had minimal background retinopathy. At follow‐up, there were no signs of retinopathy in 93 patients (79%), 22 (19%) had minimal background retinopathy, and two had developed moderate background retinopathy. Out of those patients who were still on diet at follow‐up, five (10%) had developed minimal background retinopathy. Mean blood glucose and HbAlc levels, registered every year during the observation period, were higher at most time points in patients who received oral agents or insulin treatment compared to those who were treated with diet only during the entire observation period. No differences were observed between patients who received oral agents and those who received insulin alone or in combination with oral agents.

Conclusion: It is suggested, that if the initial retinal examination reveals no or minimal diabetic retinopathy at the time of diagnosis of type 2 diabetes mellitus, the second examination can be postponed at least 4 years in patients with good metabolic control on diet treatment only.
Hyaluronan in the exfoliation syndrome
Authors: Fitzsimmons Thomas D. , Fagerholm Per , Wallin Örjan
Published: May 2009

Purpose: To histochemically analyze if the glycoseaminoglycan component of pseudoexfoliation material consists of hyaluronan.

Methods: The hyaluronan binding region of cartilage proteoglycans was utilized in a staining specific for hyaluronan. The technique has been described and employed previously. Human donor eyes with and without the presence of visible pseudoexfoliations were analyzed.

Results: Hyaluronan was found to coat the fibrillar exfoliation material on the lens, the zonules, the iris epithelium and the ciliary body. It was also found on a capsular bag following cataract surgery.

Conclusion: In the anterior chamber hyaluronan constitutes one part of the exfoliation material. Abnormal findings of hyaluronan could be found in the cornea.
Visual development in healthy eyes from 24 months to four years of age
Authors: Lithander Joan
Published: May 2009

The study is of visual development from 24 months to 4 years of age. The O‐test was used in children from 24 to 27 months of age; and the Kolt‐test from 28 months to 4 years. One measurement was performed in both eyes of 89 normal children aged from 24 months to 4 years. The mean visual acuity was 0.48 at 24 to 29 months; 0.55 at 30 to 35 months; 0.67 at 36 to 41 months; 0.77 at 3 1/2 to 4 years of age.
Phaco‐emulsification of cataract in eyes with glaucoma
Authors: Peräsalo Ritva
Published: May 2009

This study was conducted to determine how phaco‐emulsification and intraocular lens (IOL) implantation influenced intraocular pressure (IOP) in eyes with glaucoma, and glaucoma medication requirements postoperatively. A retrospective clinical analysis was undertaken of 226 eyes of 182 glaucoma patients who had undergone phacoemulsification and IOL implantation. IOP on the first day after operation increased from a preoperative mean of 17.1 mmHg (SD ± 3.9 mmHg) to a mean of 20.7 mmHg (SD ± 9.0 mmHg). One week after operation the average IOP was 17.4 mmHg (SD ± 5.5 mmHg). One year after operation the average IOP had declined to 15.3 mmHg (SD ± 3.1 mmHg). One year after operation 34% of the patients did not need glaucoma medication. If glaucoma is fairly well controlled (mean IOP preoperative 17.1 mmHg) phacoemulsification alone can result in satisfactory IOP control in eyes with capsular and primary open‐angle glaucoma.
A population‐based retrospective study
Authors: Haugen Olav H. , Markestad Trond
Published: May 2009

We have investigated the incidence of retinopathy of prematurity (ROP) among premature infants with birth weight less than 1500 g in two Norwegian counties during the years 1989–1993. Two hundred and seven out of 244 such infants (84.8%) were examined at the neonatal intensive care unit; 66 of those examined (31.9%) had a birth weight below 1000 g. ROP was found in 21 patients (10.1%), and stage 3 disease was present in 7 (3.4%). No patient had more advanced ROP than stage 3. Assuming that no cases of stage 3 ROP were missed among the total of 244 children, the incidence of stage 3 disease was 2.9%. The frequency of ROP in this study is compared to that of other population‐based studies in the Nordic countries, and incidence differences are discussed.
Wolfring dacryops and needling
Authors: O'Duffy Desmond , Watts Patrick
Published: May 2009

Cysts of the accessory lacrimal gland of Wolfring are uncommon in Europe; they are commoner in areas where trachoma is endemic and usually occur in eyes with some evidence of past trachomatous scarring (Bullock et al. 1986). The recommended mode of management is surgical, using an operating microscope, with an incision through the conjunctiva. Simple aspiration is inappropriate since the cyst refills. We describe a case of dacryops of the glands of Wolfring in a Caucasian male with no evidence of previous trachoma. This was managed with simple needling of the cyst. There was no recurrence of the cyst at 2 years follow‐up.
The long‐term follow‐up of a highly myopic patient with a macular vortex vein
Authors: Ohno‐Matsui Kyoko , Morishima Naoto , Teramatsu Tohru , Tokoro Takashi , Nakagawa Tsuneaki
Published: May 2009

We followed a highly myopic patient with a macular vortex vein for 11 years. His refraction was −12 D OU at age 10 years when the vein was first observed ophthalmoscopically in the left eye. Eleven years later, his myopia had progressed (4 diopters OD; 8 diopters OS), and the axial lengths were elongated (+1.8 mm OD; +2.7 mm OS). The macular vortex vein was dilated and tortuous. Indocyanine green angiography revealed the outflow route of this vein in the posterior pole, where both nasal and temporal posterior choroidal venous blood collected. Computed tomography showed that the vein left the eyeball directly and coursed along the optic nerve 5 mm posterior to the optic disc. A major collecting channel of posterior choroid outflow in some highly myopic eyes, a macular vortex vein may be formed at a relatively early age, and continue to enlarge, with elongation of axial length and progression of myopia.
Binding Site Distribution of Nuclear Transport Receptors and Transport Complexes in Single Nuclear Pore Complexes
Authors: Kahms Martin , Lehrich Philipp , Hüve Jana , Sanetra Nils , Peters Reiner
Published: May 2009

Transport through the nuclear pore complex (NPC) involves a large channel and an abundance of binding sites for nuclear transport receptors (NTRs). However, the mechanistically important distribution of NTR‐binding sites along the channel is vividly debated. In this study, we visualized binding site distributions directly by two complementary optical super‐resolution methods, single‐molecule microscopy and 4Pi microscopy. First, we analyzed the distribution of RanGDP because this important nuclear transport substrate has two types of binding sites at the NPC, direct and indirect, NTR‐mediated sites. We found that the direct binding sites had a maximum at approximately −30 nm with regard to the NPC center, whereas the indirect transport‐relevant binding sites peaked at approximately −10 nm. The 20 nm‐shift could be only resolved by 4Pi microscopy because of a two to threefold improved localization precision as compared with single‐molecule microscopy. Then we analyzed the distribution of the NTR Kapβ1 and a Kapβ1‐based transport complex and found them to have also binding maxima at approximately −10 nm. These observations support transport models in which NTR binding sites are distributed all along the transport channel and argue against models in which the cytoplasmic entrance of the channel is surrounded by a large cloud of binding sites.
Sorting of MHC Class II Molecules into Exosomes through a Ubiquitin‐Independent Pathway
Authors: Gauvreau Marie‐Élaine , Côté Marie‐Hélène , Bourgeois‐Daigneault Marie‐Claude , Rivard Louis‐David , Xiu Fangming , Brunet Alexandre , Shaw Andrew , Steimle Viktor , Thibodeau Jacques
Published: May 2009

Major histocompatibility complex class II (MHC‐II) molecules accumulate in exocytic vesicles, called exosomes, which are secreted by antigen presenting cells. These vesicles are released following the fusion of multivesicular bodies (MVBs) with the plasma membrane. The molecular mechanisms regulating cargo selection remain to be fully characterized. As ubiquitination of the MHC‐II β‐chain cytoplasmic tail has recently been demonstrated in various cell types, we sought to determine if this post‐translational modification is required for the incorporation of MHC‐II molecules into exosomes. First, we stably transfected HeLa cells with a chimeric HLA‐DR molecule in which the β‐chain cytoplasmic tail is replaced by ubiquitin. Western blot analysis did not indicate preferential shedding of these chimeric molecules into exosomes. Next, we forced the ubiquitination of MHC‐II in class II transactivator (CIITA)‐expressing HeLa and HEK293 cells by transfecting the MARCH8 E3 ubiquitin ligase. Despite the almost complete downregulation of MHC‐II from the plasma membrane, these molecules were not enriched in exosomes. Finally, site‐directed mutagenesis of all cytoplasmic lysine residues on HLA‐DR did not prevent inclusion into these vesicles. Taken together, these results demonstrate that ubiquitination of MHC‐II is not a prerequisite for incorporation into exosomes.
Connexin 33 Impairs Gap Junction Functionality by Accelerating Connexin 43 Gap Junction Plaque Endocytosis
Authors: Carette Diane , Gilleron Jérome , Decrouy Xavier , Fiorini Céline , Diry Monique , Segretain Dominique , Pointis Georges
Published: May 2009

Connexin 33 (Cx33) is a testis‐specific gap junction protein. We previously reported that Cx33 exerts dominant‐negative effect on gap junction intercellular communication by sequestering Cx43 within early endosomes in Sertoli cells. However, the molecular mechanisms that drive this process are unknown. The present study analyzed: (i) the trafficking of Cx33 and Cx43 in wild‐type Sertoli cells transfected with Cx33‐DsRed2 and Cx43‐green fluorescent protein vectors; (ii) the formation of heteromeric Cx33/Cx43 hemi‐channels and their incorporation into gap junction plaques. Fluorescence lifetime imaging microscopy‐fluorescence resonance energy transfer and videomicroscopy studies demonstrated that Cx33 and Cx43 associated to form heteromeric oligomers that trafficked along microtubules to the plasma membrane. However, the plaques containing Cx33 were not functional. Immunoprecipitation experiments revealed that zonula occludens‐1 (ZO‐1), a scaffold protein proposed to secure Cx in gap junction plaques at the cell–cell boundary, associated with Cx33 in testis extracts. In cells expressing Cx33, Cx33 and ZO‐1 specifically interacted with P1 phosphorylated and P0 unphosphorylated isoforms of Cx43, and the ZO‐1 membranous signal level was reduced. It is suggested that alteration of Cx43/ZO‐1 association by Cx33 could be one mechanism by which Cx33 exerts its dominant‐negative effect on gap junction plaque.
Temporal alterations in brain water diffusivity in neonatal meningitis
Authors: Malik Gyanendra K , Yadav Abhishek , Trivedi Richa , Srivastava Arti , Prasad Kashi N , Gupta Rakesh K
Published: May 2009

Aim:  To compare changes in apparent diffusion coefficient (ADC) in neonatal meningitis using serial diffusion‐weighted imaging (DWI).

Method:  Thirty neonates with meningitis and 12 age/sex‐matched controls were studied using DWI. ADC was quantified by placing region of interest(s) on periventricular white matter during acute illness and again at 21 days. Three groups of patients were studied: those with normal findings on both conventional MRI and DWI, those with abnormal DWI only and those with abnormal conventional MRI as well as DWI. Neurodevelopment assessment was performed in controls and patients at 3 months using Indian adaptation of Bayley scales of infant development (BSID) kit.

Results:  Patients with neonatal meningitis with normal imaging (n = 8) showed no significant difference in ADC compared to controls. Patients showing abnormality only on DWI (n = 10) and on both conventional magnetic resonance imaging (MRI) as well as DWI (n = 12) had significantly reduced ADC (p = 0.001) than controls at baseline study. Follow‐up study showed no significant differences in ADC in controls compared to any patient group. Significantly reduced neurodevelopmental scores were observed in patient groups compared to controls.

Conclusion:  We conclude that quantitative ADC may detect meningitis‐induced hypoxia early in brain parenchyma, which may be associated with abnormal motor and mental development.
Non‐metastatic cholestatic paraneoplastic syndrome associated with soft tissue sarcoma
Authors: BAL Amanjit , DUTTA Usha , DAS Ashim , KOCCHAR Rakesh , SINGH Kartar
Published: May 2009

Paraneoplastic syndromes have been described in association with variety of malignant neoplasms. The non‐metastatic cholestatic paraneoplastic syndrome first described as Stauffer's syndrome in association with renal cell carcinomas is also associated with other malignancies. We describe the autopsy findings of a patient with recurrent and metastatic leiomyosarcomas presenting with cholestatic liver dysfunction. The diagnosis requires the exclusion of all other possible causes of hepatitis and, where possible, resolution after the effective treatment of the underlying malignancy.
Human papillomavirus infection and premalignant lesions of the oral cavity: A cross‐sectional study in Allahabad, North India
Authors: DEBANTH Sharmistha , SINGH Premala Anthony , MEHROTRA Ravi , SINGH Mangal , GUPTA Subhash Chandra , PANDYA Shruti , CHOWDHURY Ajay , SINGH Mamta
Published: May 2009

Aim: To assess the role of human papillomavirus (HPV) in premalignant lesions of the oral cavity using the second‐generation Hybrid Capture assay kit (Digene Corporation) and to study the correlation between this technique and morphological changes (koilocytosis) on histopathology in those lesions.

Methods: A hospital‐based cross‐sectional study was undertaken including 92 patients with premalignant lesions of the oral cavity (the study group) and a control group of 35 patients with no oral disease. All the participants were interviewed regarding possible risk factors. Oral exfoliated cells in the saliva were tested for HPV DNA using an HPV RNA probe of 13 high‐risk HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68). Simultaneously biopsy specimens of the lesions were examined under a light microscope for evidence of koilocytosis, an empirical marker for HPV infection. Pearson's χ2test using SPSS V.16 was applied for statistical analysis.

Results: HPV DNA was detected in 44.6% of the study group (41 out of 92), and 14.3% of the controls (five out of 35). The association was independent of the influence of betel quid and tobacco chewing, two established causal factors for oral pre‐cancers. Out of the total 92 participants in the study group there was evidence of koilocytosis on the histological sections of 42 individuals (45.6%).

Conclusion: The results support a strong association between HPV infection and oral premalignant lesions, particularly oral lichen planus and squamous papilloma. Koilocytosis on histology is a good predictor of HPV infection.
A couple with gastrointestinal stromal tumor (GIST)
Authors: POURSOLTAN Pirooz , BEGBIE Stephen
Published: May 2009

We present a 70‐year old woman with metastatic gastrointestinal stromal tumor (GIST) and her partner, a 79‐year old man with multiple gastric GIST tumors. This tumor is considered a rare malignancy with a reported incidence of 6–13 new cases per million. Our patients were found to have different genetic mutations in the C‐KIT gene as the cause of their disease but, given the rarity of this tumor, it raises a question about their possible exposure to carcinogens or another shared mechanism that might have been involved in the pathogenesis of this cancer.
Toxicity of docetaxel plus cyclophosphamide as adjuvant therapy for breast cancer in Chinese patients – the Hong Kong experience
Authors: YAU Tsz‐Kok , NG Ting‐Ying , SOONG Inda Sung , CHOI Chi‐Wai , LAM Ka‐On , NG Alice Wan‐Ying , LEE Anne Wing‐Mui , TUNG Yuk
Published: May 2009

Aims:  The docetaxel and cyclophosphamide (TC) regimen is increasingly popular as adjuvant chemotherapy for operable breast cancers. We conducted a retrospective study in Hong Kong to evaluate the toxicity of this regimen in Chinese patients.

Methods:  Between January 2007 and May 2008 76 female Chinese patients with resected stage I–III operated invasive breast cancer were treated with 4 cycles of TC (75 and 600 mg/m2, respectively, administered i.v. every 3 weeks for four cycles) in two public regional cancer centers of Hong Kong. A total of 24 (32%) patients also received primary prophylactic ciprofloxacin (500 mg twice daily, day 5–14). Chemotherapy‐related toxicities were graded by the CTCAE version 3.0.

Results:  The median age was 50 (range 26–67). A total of 68 (89%) patients successfully completed four cycles of chemotherapy. 72 (95%) and 16 (21%) patients developed grade 3–4 neutropenia and febrile neutropenia (FN) infection, respectively, in one or more cycles. However, no grade 3–4 anemia or thrombocytopenia events were observed. Other grade 3–4 non‐hematological toxicities were also uncommon, apart from allergic reactions in two (3%) patients. No viral reactivation was observed among the 8 hepatitis B carriers. Patients with prophylactic ciprofloxacin had less grade 3–4 FN infection (13% vs 25%, P = 0.214) and a higher chance of receiving the full scheduled dose (88% vs 62%, P = 0.045) than patients without.

Conclusion:  The myelotoxicity of TC was substantially higher in Chinese patients compared with non‐Chinese patients in developed countries. Routine prophylactic measures are recommended to maintain the dose levels and reduce the risk of FN.
Risk of venous thromboembolism in patients receiving adjuvant chemotherapy with 5‐fluorouracil, epirubicin and cyclophosphamide for early breast cancer
Authors: HOY Julia , NEEMAN Teresa , STUART‐HARRIS Robin , DAVIS Alison
Published: May 2009

Aim:  Previous studies have shown that adjuvant chemotherapy in early breast cancer (EBC) may increase the risk of venous thromboembolism (VTE). Clinical experience suggests the combination of 5‐fluorouracil, epirubicin and cyclophosphamide (FEC) may be associated with a higher frequency of VTE than other regimens. This study aims to investigate the use of adjuvant FEC compared with other adjuvant regimens in the development of VTE in patients with EBC.

Methods:  A retrospective audit was conducted examining all eligible patients who received adjuvant chemotherapy for EBC in the Australian Capital Territory from 1 January 2005 to 30 June 2007. Data were collected from patients' notes, including risk factors for VTE, tumor pathology, chemotherapy details and incidence of VTE. Comparisons using χ2 tests and independent samples t‐tests were made between patients who received FEC and those who received another regimen. Multivariate logistic regression was used to investigate prognostic factors for the development of VTE.

Results:  A total of 325 patients were included in the study, of whom 176 received FEC and 149 received other adjuvant chemotherapy regimens. The incidence of VTE in patients who received FEC was 47/176 (27%), which was significantly higher than for patients who received other regimens (7/149, 5%, P < 0.001). FEC was the only significant prognostic factor for the development of VTE (OR 7.9, 95% CI 3.3–19.2, P < 0.001).

Conclusion:  The use of adjuvant FEC chemotherapy is associated with an increased incidence of VTE in patients with EBC compared with other commonly used chemotherapy regimens.
Decreased Factor XIII Activity in a Patient With Subcutaneous Bleeding After Double Filtration Plasmapheresis
Authors: Seishima Mariko , Shibuya Yoshinao , Kato Genichi , Aoki Takahiko
Published: May 2009

Double filtration plasmapheresis (DFPP) is often performed as a treatment for autoimmune diseases including pemphigus vulgaris. We report a pemphigus vulgaris patient with subcutaneous bleeding, gradually spreading over a period of 10 days after DFPP. In this patient, factor XIII activity was markedly decreased. In three other patients, factor XIII activities were markedly reduced the day following DFPP, were but restored by days 7–10. From these findings, subcutaneous bleeding may have occurred in the present patient due to a delayed recovery of the decreased factor XIII activity after DFPP. Therefore, decreased factor XIII activity could be a critical cause of subcutaneous bleeding after DFPP.
A Case Report of Severe Visceral β2‐Microglobulin‐derived Amyloidosis Without Obvious Joint Symptoms or Radiological Findings in a Chronic Hemodialyzed Patient With Systemic Lupus Erythematosus
Authors: Koda Ryo , Yamazaki Hajime , Kazama Junichiro , Ito Tomoyuki , Saeki Takako , Emura Iwao , Miyamura Syoji , Narita Ichiei , Gejyo Fumitake
Published: May 2009

Beta‐2‐microglobulin‐derived amyloidosis (Aβ2M amyloidosis) is a critical complication for patients undergoing long‐term renal replacement therapy. Osteoarticular lesions, rather than visceral organs, are susceptible to this type of amyloidosis, and the visceral form seems to occur at a relatively late stage. Herein, we report a case of severe visceral Aβ2M amyloidosis without obvious joint symptoms or radiological findings in a chronic hemodialyzed patient who had received long‐term treatment with glucocorticoid steroids for systemic lupus erythematosus. It should be noted that prominent visceral Aβ2M amyloidosis can develop without any osteoarticular symptoms or radiological abnormalities in dialyzed patients undergoing prolonged glucocorticoid therapy.
The Problem of Natural Evil I: General Theistic Replies
Authors: Gelinas Luke
Published: May 2009

I examine different strategies involved in stating anti‐theistic arguments from natural evil, and consider some theistic replies. There are, traditionally, two main types of arguments from natural evil: those that purport to deduce a contradiction between the existence of natural evil and the existence of God, and those that claim that the existence of certain types or quantities of natural evil significantly lowers the probability that theism is true. After considering peripheral replies, I state four prominent theistic rebutting strategies: skeptical theism; Richard Swinburne's view that moral knowledge entails natural evil; the soul‐making theodicy; and the natural law theodicy.
SJL Mice Exposed to Cuprizone Intoxication Reveal Strain and Gender Pattern Differences in Demyelination
Authors: Taylor Lorelei C. , Gilmore Wendy , Matsushima Glenn K.
Published: May 2009

The role of mouse strain and the influence of gender on demyelination were explored for the first time in SJL mice using the cuprizone intoxication model. We document here that SJL mice display a unique pattern of demyelination that did not follow the profile that is well‐characterized in C57BL/6 mice. The SJL mice did not readily demyelinate at the midline within the corpus callosum but showed greater demyelination immediately lateral to midline. During continuous exposure to cuprizone, demyelination was not complete and appeared to plateau after week 7. Importantly, female mice were partially resistant to demyelination, whereas male mice were more severely demyelinated. Differences in the number of mature oligodendrocytes were consistent with the extent of demyelination; however, microglia, astrocyte and oligodendrocyte precursor cell populations did not differ between male and female mice. Thus, genetic factors and gender influence susceptibility to demyelinating disease in the cuprizone model, which may provide additional insights into the variability observed in human demyelinating diseases such as multiple sclerosis.