bluuebunny/crossref_metadata_2025 huggingface dataset:
Caspase‐1 Activation is Increased with Human Labour in Foetal Membranes and Myometrium and Mediates Infection‐Induced Interleukin‐1β Secretion
Authors: Lappas Martha
Published: November 2013

Problem

Interleukin‐1β (IL‐1β) is a pro‐inflammatory cytokine that is involved in human parturition, especially in the context of infection‐induced preterm birth. Caspase‐1 is a key component of inflammasomes, which are activated upon infection to trigger the maturation of IL‐1β.

Method of study

To determine the effect of human labour on caspase‐1 activation in human foetal membranes and myometrium. In addition, the mechanisms by which inflammasome activation regulates IL‐1β production were also be assessed.

Results

Higher caspase‐1 gene and protein expression were detected in foetal membranes myometrium obtained from term labouring women when compared with samples taken from non labouring women. Lipopolysaccharide induced the transcription and secretion of IL‐1β from foetal membranes and myometrium; both events were dependent on nuclear factor kappa B (NF‐κB). However, levels of extracellular IL‐1β were greatly increased by subsequent treatment with the potassium‐proton ionophore Adenosine triphosphate (ATP) or nigericin; an effect that was dependent on active caspase‐1. Additionally, ATP induced IL‐1β secretion via the purinergic P2X7 receptor, whereas the pannexin‐1 channel was required for nigericin induced IL‐1β secretion.

Conclusion

Taken together, these results demonstrate that caspase‐1 activation is increased with human labour in foetal membranes and myometrium, and is required for infection‐induced IL‐1β secretion.
In Vitro Performance Analysis of a Novel Pulsatile Diagonal Pump in a Simulated Pediatric Mechanical Circulatory Support System
Authors: Wang Shigang , Kunselman Allen R. , Ündar Akif
Published: November 2013

The objective of this study was to evaluate the pump performance of the third‐generation Medos diagonal pump, the Deltastream DP3, on hemodynamic profile and pulsatility in a simulated pediatric mechanical circulatory support (MCS) system. The experimental circuit consisted of a Medos Deltastream DP3 pump head and console (MEDOS Medizintechnik AG, Stolberg, Germany), a 14‐Fr Terumo TenderFlow Pediatric arterial cannula and a 20‐Fr Terumo TenderFlow Pediatric venous return cannula (Terumo Corporation, Tokyo, Japan), and 3 ft of tubing with an internal diameter of in. for both arterial and venous lines. Trials were conducted at flow rates ranging from 250 mL/min to 1000 mL/min (250‐mL/min increments) and rotational speeds ranging from 1000 to 4000 rpm (1000‐rpm increments) using human blood (hematocrit 40%). The postcannula pressure was maintained at 60 mm Hg by a Hoffman clamp. Real‐time pressure and flow data were recorded using a Labview‐based acquisition system. The pump provided adequate nonpulsatile and pulsatile flow, created more hemodynamic energy under pulsatile mode, and generated higher positive and negative pressures when the inlet and outlet of the pump head, respectively, were clamped. After the conversion from nonpulsatile to pulsatile mode, the flow rates and the rotational speeds increased. In conclusion, the novel Medos Deltastream DP3 diagonal pump is able to supply the required flow rate for pediatric MCS, generate adequate quality of pulsatility, and provide surplus hemodynamic energy output in a simulated pediatric MCS system.
Development of Dual‐Setting Calcium Phosphate Cement Using Absorbable Polymer
Authors: Thürmer Mônica Beatriz , Diehl Carlos Eduardo , Brum Fábio José Bento , dos Santos Luís Alberto
Published: November 2013

Calcium phosphate cements used as bone substitutes generally have low mechanical strength compared with the bones of the human body. To solve these needs, we have incorporated hydrogels in the manufacture of samples made of alpha‐tricalcium phosphate (α‐TCP) cement, developing a system of dual‐setting cement. This study aimed to produce composite materials by combining α‐TCP powder and hydrogels. The composites were prepared using the synthesized powder and four different formulations of hydrogels, using either poly(N‐vinyl‐2‐pyrrolidone) or poly(N‐vinyl‐2‐pyrrolidone–co‐acrylic acid), with either azobisisobutyronitrile or ammonium persulfate as initiator. The properties of all composites were evaluated through measuring compressive strength and apparent density and through X‐ray diffraction and scanning electron microscopy. The composites showed compressive strengths of around 24 MPa. Soaking the samples in simulated body fluid formed a layer of hydroxyapatite‐like crystals on the surface of some samples, showing the bioactivity of the newly developed cements and their potential use as biomaterial.
Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (Crow–Fukase) syndrome: Diagnostic criteria and treatment perspectives
Authors: Misawa Sonoko , Kuwabara Satoshi
Published: November 2013

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS; Crow–Fukase) syndrome is a devastating disorder related to plasma cell dyscrasia, characterized by polyneuropathy, organomegaly, edema/effusion, M‐protein and skin changes. Novel therapeutic approaches can substantially improve the prognosis. Diagnosis of POEMS syndrome is often challenging because of a combination of clinical presentations. To facilitate precise and early diagnosis, a comprehensive systemic survey is essential, and we propose that current diagnostic criteria should be modified. The current first‐line therapy is high‐dose chemotherapy with autologous stem cell transplantation, whereas patients who are not eligible for transplantation because of older age or poor general condition, are treated with immunomodulatory drugs, such as thalidomide or lenalidomide. The prognosis of POEMS syndrome has been substantially improved by these novel interventions. However, how to treat very young patients and those with a relapse after autologous stem cell transplantation is controversial. Until the 2000s, therapeutic approaches initially aimed at lifesaving (or short‐term improvement), but recent treatment advances could achieve long‐term remission of the disease. A treatment algorithm should be decided from the viewpoint of disease control over a decade. Elucidation of the natural history of the disease and well‐conducted randomized control studies are fundamental to establish a proper therapeutic guideline. The present review focuses on recent advances in the diagnosis and treatment of POEMS syndrome, and discusses future perspectives of therapeutic strategies.
Boldness and Stress Responsiveness as Drivers of Nest‐Site Selection in a Ground‐Nesting Bird
Authors: Seltmann Martin W. , Jaatinen Kim , Steele Benjamin B. , Öst Markus
Published: November 2013

Nest‐site selection involves trade‐offs between the probability of nest discovery by egg predators, danger to the incubating parent from predators and provision of an appropriate microclimate for incubation, and all three components are potentially influenced by nest concealment and distance to habitat edge. Personality traits also affect habitat choice, and the trade‐off hypothesis suggests that variable stress‐coping strategies may evolve because individuals prioritize either productivity (proactive coping) or survival (reactive coping), both of which cannot be simultaneously maximized. Applying this hypothesis to understand nest‐site selection by female eider ducks (Somateria mollissima), we predicted that bold individuals with attenuated stress responsiveness should select concealed nests further away from the shore, thereby promoting clutch survival at the potential expense of reduced escape opportunities for themselves. In testing this prediction, we controlled for individual quality (female body condition and breeding experience) and verified that individual stress responses and nest‐site preferences were consistent by analysing their repeatability. Finally, we analysed how the viable proportion of the clutch was related to nest‐site and female characteristics. Our prediction was supported: bold females [short flight initiation distance (FID)] and those with lower handling‐induced body temperature were found in concealed nests, and bold females and those with lower handling‐induced corticosterone concentrations occupied nests farther from the shore. The viable proportion of the clutch peaked at intermediate proportional nest‐cover and increased linearly with increasing nest distance from the shore. Stress coping styles may thus be related to nest‐site selection, but their fitness consequences may be manifested indirectly through the nest‐site characteristics.
Imagined Communities and Language Learning During Study Abroad: Arabic Learners in Egypt
Authors: Trentman Emma
Published: November 2013

Previous research on study abroad has documented extensive variation in the amount of contact students have with members of the local community as well as in their linguistic outcomes (Kinginger, 2009). This article uses the theoretical concepts of investment, imagined communities, and communities of practice to interpret data obtained from students studying abroad in Egypt. Data show that these students wanted to belong to an imagined community of study abroad in the Middle East by demonstrating the identities of cross‐cultural mediator and dedicated language learner. However, the communities of practice in which they participated while abroad afforded differential opportunities to demonstrate these identities, resulting in both alignments and misalignments between reality and imagination. The degree of alignment between students' expectations and the realities that they encountered may help explain the extensive variation in students' access to Egyptians and their use of the Arabic language.
Cementation and the hydromechanical behavior of siliciclastic aquifers and reservoirs
Authors: Boutt D. F. , Plourde K. E. , Cook J. , Goodwin L. B.
Published: November 2013

Progressive cementation and lithification significantly influence the mechanical and hydrologic properties of granular porous media through elastic stiffening and permeability reduction. We use published data that quantify the effect of grain‐bridging cement distribution in granular porous media at the grain scale to investigate the influence of variable cement content on the competing roles of hydrologic and mechanical effects on fluid flow and deformation at the reservoir scale. The impact of quartz overgrowths in natural samples was quantified using a bond‐to‐grain ratio, allowing a geologically meaningful interpretation of percent cement in conceptual models of quartz cementation. An increase in the bond‐to‐grain ratio from 1 to 2.2 (~1–15% cement by volume) results in a 1.4‐fold increase in Young's modulus and an ~1000‐fold decrease in permeability. The hydromechanical properties of a suite of variably cemented natural samples are used as input into two‐dimensional, kilometre‐scale, axially symmetric poroelastic models of an isotropic confined aquifer. Models isolating the hydrologic and mechanical effects of cementation indicate that the hydrologic properties dominate the overall mechanical response, controlling both the volume and magnitude of deformation. Incorporation of changes in hydrologic properties due to cementation is therefore essential to capturing the first‐order physics of coupled aquifer behavior.
Effect of wheat sprout powder incorporation on lipid oxidation and physicochemical properties of beef patties
Authors: Ozturk Ismet , Sagdic Osman , Tornuk Fatih , Yetim Hasan
Published: November 2013

The aim of this study was to determine the effects of incorporation of wheat sprout flours (WSF) on lipid oxidation and some quality characteristics of beef patties. Two wheat sprout flour samples (WSF1 and WSF2) were obtained by germination, drying and milling of two different wheat varieties. The beef patties were stored at +4 °C for 6 days or at −18 °C for 180 days and analysed for their proximate composition, pH, sensory properties, colour parameters and lipid oxidation. TBA formation in WSF‐added patties was reduced approximately by as much as 20% when compared to that of the control at the 180th day of the storage, while favourable results were detectable in the storage period at +4 °C. Again, up to 4% WSF1 or WSF2 incorporation gave acceptable sensorial scores to the beef patties. As a conclusion, it was confirmed that WSF could be incorporated into beef patties to improve their quality parameters and retard lipid peroxidation.
Chemical composition, functional properties and microstructural characteristics of three kabuli chickpea (Cicer arietinum L.) as affected by different cooking methods
Authors: Xu Yixiang , Thomas Melissa , Bhardwaj Harbans L.
Published: November 2013

Chickpea is an important food legume and is a major ingredient in many human diets. Chemical composition, physical parameters, functional properties and microstructural characteristics of three kabuli chickpea cultivars and the effects of three cooking methods were investigated. Carbohydrate and protein were two major components in all seeds. Cooking increased fibre, total carbohydrate and total and resistant starch contents, but decreased ash content. Protein and oil levels of the cooked samples either decreased or did not change significantly. Seed weight and density decreased with cooking. Hydration and swelling capacities as well as water absorption and holding capacities of cooked chickpeas were higher than raw samples, with the largest increases in the pressure‐cooked seeds. Seed weights were highly correlated with hydration (r = 0.89) and swelling (r = 0.76) rates. Emulsifying activity, emulsifying stability and foaming capacity of cooked chickpea flours decreased, while foaming stability increased. Chickpea flours had pronounced morphological changes after cooking.
Heritage Lecture: Major Central European’s contributions to international ophthalmology
Authors: GRZYBOWSKI A
Published: November 2013

Major Central European’s contributions to international ophthalmology The fundamentals of modern ophthalmology were created in Europe in 18th and 19th centuries. At that time, Central European states were not independent, and majority were occupied by neighbouring countries, like Russia, Prussia and Austro‐Hungary. This political situation significantly limited the development of science and medicine in those countries. Scientific development was hindered by such factors as poor investment in research, decreased number of universities, emigration of some researchers due to political reasons or due to the lack of adequate academic background. In spite of numerous complications, many interesting discoveries and observations were made in Central Europe at that time, even though the origin of most of them is now forgotten. The aim of this study is to present some major achievements of important contributors to international ophthalmology originating from Central Europe, including Witelo, Purkinje, Szokalski, Wicherkiewicz, Galezowski, Borysiekiewicz, Goldzieher, Blaskovics, Imre Jr., Kettesy, Krwawicz, Wilczek, Wichterle and others.
Posture face‐down or not? The best tamponade
Authors: FRIMPONG‐ANSAH K
Published: November 2013

Post‐operative posturing is an ardous and inconvenient process not without adverse effects. The purpose of this presentation is to assess whether or not carrying out face‐down post operative posturing after macular hole surgery provides any benefit to the patient. A review has been carried out of current literature including randomised controlled trials and Cochrane Review related to posturing / positioning following macular hole surgery. The results of this review shows that there is no single clear conclusive approach. There may however be some situations, such as macular hole size which may have a bearing on the choice of whether or not to posture. Future randomised controlled trials may shed more light on this area of ophthalmic management.
Gonioscopy? Yes I can!
Authors: HOMMER A
Published: November 2013

Gonioscopy is an essential examination in Glaucoma care. There is no other technique available that can replace it. Differential diagnosis of the different types of glaucoma is not possible without it. This course will highlight the different lenses, examination technique, findings and classifications. It will be shown with Videos, Computer animation as well as clinical cases.
Prospects: Dietary ω‐3 polyunsaturated fatty acids, CCR2+ monocyte recruitment, and AMD?
Authors: SENNLAUB F
Published: November 2013

Oxidative stress is thought to be an important player in the development of atrophic AMD. Chronic photo‐oxidative stress induced phospholipid oxidation increases the expression of C‐C motif chemokine 2 (CCL2), which is known to recruit CCR2+ monocyte in inflammatory process. Their possible role in promoting or inhibiting retinal degeneration is unknown. We show that atrophic AMD is associated with increased intraocular CCL2 levels and subretinal CCR2+ inflammatory monocyte infiltration in patients. Using age‐ and light‐induced subretinal inflammation and photoreceptor degeneration in Cx3cr1 deficient mice, we show that genetic deletion of CCL2 or CCR2 and pharmacological inhibition of CCR2 prevents inflammatory monocyte recruitment, mononuclear phagocyte accumulation, and photoreceptor degeneration in vivo. Dietary ω‐3 polyunsaturated fatty acids (PUFA) have been shown to inhibit CCL2 induction and inflammation in endotoxin‐induced uveitis. They might represent a powerful tool for controlling inflammation and neurodegeneration in AMD.
How to handle the dietary requirements in clinical practice in ophthalmology
Authors: CREUZOT C
Published: November 2013

Abstract not provided
The new clinical applications of dried amniotic membrane
Authors: HOPKINSON A , ALLEN C , DUA HS
Published: November 2013

Dried amniotic membrane (AM) can be a useful therapeutic adjunct in ophthalmic surgery and possesses logistical advantages over standard cryopreserved AM. Differences in preservation techniques can significantly improve biochemical composition and physical properties of AM, potentially affecting clinical efficacy. Nottingham have developed a novel dry AM preparation comparable in biochemistry to fresh membrane and with superior in vitro wound healing capability than conventional cryopreserved and freeze dried AM. This product is stable and easily transportable allowing it to be globally wide reaching for use in clinical and military sectors, and can be stored as a stock item. Allowing such an ‘off the shelf’ application, creates a novel standardised biological dressing in emergency situations for enhanced wound healing and improved clinical prognosis. Their pre‐clinical data generated from treatment of ocular burns demonstrates the benefit of acute phase innervation with an effective treatment such as dry AM.
Amniotic membrane as a tissue engineering substrate
Authors: BRANCH M
Published: November 2013

Amniotic membrane (AM) is commonly used for cell culture and transplantation onto the ocular surface. AM serves the dual purpose of culture substrate and scaffold thus reducing cell manipulation. Crucially AM is believed to promote the retention of stem cell phenotypes essential for the long term restoration of functional tissue. As potential cellular therapies for corneal regeneration are being developed many of them continue to use AM. Its widespread usage in ophthalmology and extensive list of wound healing attributes has made AM a popular choice. Amniotic membrane is being used as a carrier for innovative research into the transplantation of non‐corneal cell types onto ocular surface burn models including mesenchymal stem cells and oral mucosal epithelium. A lack of standardisation in the preparation of amniotic membrane can cause considerable variation and some methods of preparation may reduce or enhance certain attributes. Various methods of processing including cross‐linking, denuding and freeze drying have sought to enhance amniotic membrane for tissue engineering purposes with varied levels of success.
B27‐associated uveitis, Fuchs uveitis
Authors: WILLERMAIN F
Published: November 2013

B27‐associated uveitis is a very frequent form of non infectious intraocular inflammation which account for approximately 50 % of acute anterior uveitis. Its main clinical features, natural history and association with seronegative arthritis are well known. Fuchs uveitis is another frequent cause of anterior and intermediate uveitis. Its natural history is well characterised as well as its association with intraocular production of anti‐rubella antibodies. Both diseases are thus often considered as easy diagnosis. However, several aspects of those diseases remain challenging and debated. In this interactive course, based on clinical cases, we will insist on those difficult aspects as well as on the more recent issues discussed in the literature.
Possibility of visual prognosis based on flash visual evoked potential in cases of early brain damage
Authors: POJDA‐WILCZEK D
Published: November 2013

Purpose To find out whether Flash Visual Evoked Potential (FVEP) may be used for observations of visual development in cases of early brain damage.

Methods 94 children at the age of 5 months to 9 years were observed. Inclusion criterion was early brain damage resulting from such diseases as hypoxic‐ischemic encephalopathy, hydrocephalus and various brain congenital malformations. Exclusion criteria were eye‐ball diseases, retinopathy of prematurity and previous ocular surgery. The first FVEP examination was carried out at the age of 5 to 18 months, the last at the age of 5 to 9 years. FVEP was done according to ISCEV standards. The amplitude and the latency of P2 wave were measured. Children were divided into two groups: with and without visual improvement during observation. U‐Mann‐Whitney test was used for statistical analysis. Receiver Operating Characteristic, threshold limit value for P2 amplitude, as well as sensitivity and specificity of FVEP were calculated.

Results In the group of children with visual improvement P2 amplitudes were significantly higher in the second examination than in the first one (rising from mean value of 7.8 µV to mean value of 11.7 µV; p=0.0036). In the group of children with no visual improvement mean value of P2 amplitudes was 2.3 µV and P2 amplitude of 6.2 µV was threshold limit value. Vision of the most children with P2 amplitudes below this value did not improve in observation period. Sensitivity of FVEP test in visual prognosis was 94% but specificity 71.4%.

Conclusion P2 amplitude of FVEP is helpful in prognosis of visual development in cases of early brain damage.
Effect of breathing 12% oxygen in nitrogen on retinal blood flow and oxygen saturation
Authors: PALKOVITS S , TOLD R , BOLTZ A , SCHMIDL D , NAPORA K , GARHÖFER G , SCHMETTERER L
Published: November 2013

Purpose It has been reported that altering the fraction of oxygen in inhaled air changes retinal arterial and venous oxygen saturation. In the present study we set out to study the effects of 12% oxygen in nitrogen breathing on retinal blood flow and retinal oxygen saturation.

Methods 30 healthy volunteers were included into the present study. Assessment of the effect of 12% oxygen in nitrogen breathing on retinal blood velocities was performed using laser Doppler velocimetry (LDV). Retinal vessel diameters were assessed with the Dynamic Vessel Analyzer (DVA, Imedos, Germany). Retinal oxygen saturation was investigated using the same instrument based on spectroscopic evaluation of the data. The effects of 12% oxygen in nitrogen breathing on systemic oxygen tension was evaluated based on arterialized blood samples drawn from the earlobe.

Results Breathing 12% oxygen in nitrogen caused systemic hypoxia as evidenced from the reduced systemic oxygen tension (p < 0.01). In addition, a reduction in both arterial and venous oxygen saturation was seen in retinal vessels (p < 0.01 each), which was more pronounced in veins. In parallel we observed an increase in retinal vessel diameters, retinal blood velocities as well as in retinal blood flow (p < 0.05 each).

Conclusion The results of the present study indicate good validity of retinal oxygen saturation measurements using the DVA. In addition, the results are compatible with unchanged retinal oxygen extraction during hypoxia.
Electrophysiology in acquired disease
Authors: HOLDER G
Published: November 2013

This presentation will address the use of electrophysiology in various acquired disorders, including vascular, nutritional, toxic, inflammatory, parasitic, autoimmune and paraneoplastic disease. A case‐based format will be used to demonstrate the contributions of electrophysiology both to diagnosis and management.
Targeting the hypoxia pathway in uveal melanoma cells
Authors: ASNAGHI L , LIN MH , LIM KS , LIM KJ , BAR EE , EBERHART CG
Published: November 2013

Uveal melanoma is the most frequent intraocular cancer in adults and cause significant mortality due to hematogenous dissemination. Hypoxia‐inducible factor 1α (HIF1α), a master regulator of the hypoxic response, is associated with aggressive uveal melanomas. Here we investigated the mechanism responsible for the prometastatic effect of HIF1α and its downstream targets. HIF1α protein was relatively abundant in the OCM1, OMM1, Mel290 and 92.1 lines grown in normoxia (21% pO2), and was further induced in hypoxia (1% pO2), as well as the mRNA levels of VEGF and LOX, two transcriptional targets of HIF1α. Interestingly, low oxygen tension increased the ability of uveal melanoma cells to invade Matrigel. Genetic suppression of HIF1α by shRNA significantly decreased growth in hypoxia (p<0.0001) and impaired cellular invasion both in normoxia and hypoxia (p<0.0001), suggesting that HIF1α is necessary for invasion even in normoxia. To determine downstream targets, we examined Notch pathway members, which we have previously linked to uveal melanoma invasion, and found that Notch ligand Jag2 and target Hey1 were induced by hypoxia, and their expression was reduced using HIF1α shRNA, suggesting a crosstalk between hypoxia and Notch pathways.
Pathophysiology of macular edema
Authors: JONAS J
Published: November 2013

The talk will present and discuss causes and treatment possibilities of macular edema in various retinal diseases.

Commercial interest
ME and Retinal Disease
Authors: AMBATI J
Published: November 2013

Abstract not provided
Pathophysiology of the development of intraocular inflammation in VKH
Authors: HERBORT C
Published: November 2013

Choroiditis has recently been classified and subdivided into choriocapillaritis when the impact of inflammation is at the level of the choriocapillsris and into stromal choroiditis when the inflammation is situated in the choroidal stroma. The choroidal stroma can be the chance localization of an infectious or non‐infectious systemic disease such as tuberculosis or sarcoidosis and is then termed secondary stromal choroiditis. The situation is different in Vogt‐Koyanagi‐Harada disease (VKH)(and birdshot retinochoroiditis) where the target of the inflammatory reaction is selectively situated in the choroidal stroma and should therefore be called primary stromal choroiditis. The choroidal inflammation develops first silently while it is still confined to the stroma. Probably this phase corresponds to the proromal stage. It is only when the inflammation spills over, usually in an explosive fashion, into neighbouring compartments such as the retina, optic disc and vitreous that the disease becomes clinically apparent.The fact that the choroidal stroma is the primum movens means that the follw‐up of choroidaql inflammation by ICGA is crucial and that therapy has a good impact as long as sustained ICGA assisted therapy is applied
Advancing age and mitochondrial dysfunction impair optic nerve recovery after IOP challenge
Authors: CROWSTON JG
Published: November 2013

Glaucoma prevalence and incidence rise non‐linearly with advancing age. The reasons for this may be multifactorial but this talk will demonstrate how advancing age and mitochondrial dysfunction in mice render the inner retina increasingly vulnerable to injury induced by short‐term IOP elevation. We will then provide data from a cohort of open angle glaucoma patients demonstrating an impairment in complex‐I‐driven respiration and ATP synthesis, compared to age‐matched controls. Put together these observations suggest that ageing and mitochondrial impairment render retinal ganglion cells vulnerable to IOP injury and this may predispose some individuals to open angle glaucoma.
Intravitreal drug dispersion and needle gauge
Authors: PEREZ‐MARTIN S , MONTERO J , MERINO A
Published: November 2013

Purpose Intravitreal injections (IV) have become the main treatment for many ocular diseases.. At present, IV are supplied with a 27G, 30G needles. Reduced ocular discomfort and scleral penetration forces have been reported after using smaller gauge needles. However, smaller inner diameter implies increased fluid speed and intraocular turbulence that may result in retinal harm

Methods IV were injected with 0.05 mL Indian ink using 27, 30 and 32 G needles. After the injection the eyes were divided in groups and the vitreous was photographed. Three masked observers scored Indian ink dispersion within the vitreous gel from 1 (completely localized) to 4 (complete dispersion).

Results Intra‐observer and inter‐observer reproducibility was between 0.78 and 0.95 and between 0.93 and 0.95, respectively (intra‐class correlation coefficient). The average Indian ink dispersion scores for 27, 30 and 32 G needles were 3.4, 2.5 and 1.8 respectively (p=0.07 for 27 vs. 32 G; p= 0.71 for 27G vs. 30G; p=0.15 for 30G vs. 32G; Student t test for unpaired data)

Conclusion The inner flow is four times faster in thinner needles, considering that the plunger slides with similar speed. We might expect that flow through the thinner needle would induce more turbulence within the vitreous gel; however, the pattern of intravitreal distribution of Indian ink suggests that the injected fluid and the turbulence were confined to a small bag in the area where smaller gauges were used. The results of this work suggest that 32G needles do not increase turbulence of injected fluid. Limited turbulence may be of even greater interest in elderly eyes with liquefied vitreous gel, reducing mechanical retinal damage
Results of a phase I/II clinical trial: standardized, non‐xenogenic, cultivated limbal stem cell transplantation
Authors: ZAKARIA N , KOPPEN C , TASSIGNON MJ
Published: November 2013

We describe the results of a phase I/II clinical trial for standardized, non‐xenogenic, cultivation and “no touch” surgical transplantation of limbal stem cell grafts. 18 eyes of 18 patients were transplanted with either autologous (n=15) or allogenic (n=3) limbo‐amnion composite grafts that were generated using a standardized culture protocol free of xenogenic culture products and transplanted using a standardized “no touch” surgical technique. In vitro cellular outgrowth and phenotype of the cultivated graft was assessed prior to transplantation. Corneal neovascularization, central corneal opacity, pain, photophobia and visual acuity were investigated pre and post transplantation. The limbal epithelial cells showed an average outgrowth of 14.2mm by day 14. The majority of the cells displayed a progenitor phenotype: p63, CK14, desmoglein, ABCG2 bright and CK3/12 dim protein expression. The transplant recipients were followed up for a mean of 22 months. 12 out of the 18 transplant recipients were graded successful, giving an overall success rate of 67%. The ocular surface photographs for pre‐ and post stem cell transplantation, showed a significant (p=0.007) reduction in the percentage area of corneal neovascularization.
Autoimmune mechanisms in primary open angle glaucoma
Authors: GRUS F
Published: November 2013

In glaucoma, the elevated intraocular pressure cannot explain the disease in all patients. However, the pathogenesis of the disease is widely unknown. Autoimmune effects could play a role in the disease process. Several studies using Western blotting, mass spectrometry and microarrays could demonstrate significant and persistent up – and downregulations of immunoreactivities against ocular antigens. Furthermore, in animal models it could be shown that in priniciple the immune reaction itself is able to lead to retinal ganglion cell loss. A deposit of antibodies could be shown in the retinae of glaucoma patients. These findings could lead to a better understanding of the pathogenesis, but also to new immunomodulatory treatment options and diagnosis.
Micronutrition; Opinion and use among European Ophthalmologists
Authors: ASLAM T
Published: November 2013

Abstract not provided
Normal and abnormal vitreoretinal interface conditions
Authors: POURNARAS CJ
Published: November 2013

Pathologic changes at the vitreoretinal interface and vitreomacular traction, lead to the phenotypic lesions as epiretinal membranes (ERMs), idiopathic macular holes, vitreomacular traction syndrome (VMTS) and myopic foveoschisis. Remnants of vitreous collagen fibers in the presence of clinically evident posterior vitreous detachment (PVD) and/or cellular proliferations of fibrous astrocytes or glial cells growing outward from the retina to the inner retinal surface through the internal limiting membrane (ILM) , in the presence of growth factors as laminin, fibronectin, may contribute to fibrocellular proliferation at the retinal surface. Most studies of idiopathic of diabetic or macular holes related epiretinal membranes, described the presence of fibrocytes or myofibroblasts and more recent studies confirmed these observations using antibodies against alpha smooth muscle actine (a‐SMA). Based on the mechanistic association between a‐SMA expression and tractional force generation, there is little doubt that these cells represented the source of traction during the evolution of those pathologies.
Assessment and classification of vitreoretinal interface disorders
Authors: TADAYONI R
Published: November 2013

Abstract not provided
The neuroscience of glaucoma in relation to the possibility for neuroprotection
Authors: OSBORNE N
Published: November 2013

Various theories exist to explain how glaucoma is initiated to result in the differential rate of retinal ganglion cell death. We suggest that initially the quality of the blood supply in the optic nerve head region is affected to cause a type of ischemia. This causes an alteration in ganglion cell mitochondrial homeostasis and an activation of astrocytes and other glia in the optic nerve head. Thereafter, as the disease progresses substances released from activated glial cells and also blue light reaching the retina act synergistically to cause the death of specific ganglion cells at different times. We therefore propose that the repertoire of receptors and number of mitochondria in individual ganglion cells relate to their time of death after glaucoma is initiated. These ideas will be presented, as they suggest that the causes and mechanisms for individual ganglion cells dying in glaucoma vary. Such a theory implies that substances with a single mode of action is unlikely to be sufficient for effective clinical neuroprotection but that this might be achievable using substances with multiple modes of action or a suitable cocktail mixture of products.
The potential role of endothelin in glaucoma
Authors: CHAUHAN B
Published: November 2013

Endothelin is a potent vasoactive peptide occurring in three isotypes (ET‐1, ET‐2 and ET‐3). Endothelin via its two main receptors ETA and ETB is responsible for a variety of physiological functions primarily blood flow control. Recent evidence from both human and experimental optic neuropathies shows involvement of endothelin and upregulation of its receptors (principally ETB). Experimental studies have shown that chronic ET‐1 administration to the optic nerve immediately behind the globe causes neuronal damage, activation of astrocytes, the major glial cell in the anterior optic nerve and upregulation of ETB receptor. This review outlines the ubiquitous role of endothelin and its potential involvement in glaucoma.
Indications and practical use of corneal crosslinking
Authors: MENCUCCI R
Published: November 2013

Indications and practical use of corneal crosslinking SUMMARY Corneal crosslinking with riboflavin and UVA irradiation is a recent and promising approach to increase the mechanical and biochemical stability of the stromal tissue in keratoconus. Nevertheless there are still unsolved issues about this procedure, such as the more effective and tolerated imbibition time, irradiation potency and riboflavin solution composition; new procedure has been proposed such as transepithelial crosslinking, accelerated crosslinking, imbibition with iontophoresis. Indication, contraindication, potential risk and benefits of these procedures will be reviewed.
Bloodless and painless pterygium surgery
Authors: GICQUEL JJ
Published: November 2013

Pterigyum is the most common surgically managed ocular surface disorder . The primary Goals are to prevent recurrences in advanced cases and get a proper esthetic result in younger patients with less symptomatic cases There has been 1 article every month for the last 4 decades on the subject… Bare sclera technique should be avoided at all costs, because it involves too many recurrences. Hence will discuss other techniques, such as conjonctivo‐limbalautograft (sutured or glued), conjunctival graft, amniotic membrane and the use of anti‐mitotic drugs.
Unique morphology of the human orbit among the Hominoidea
Authors: DENION E , HITIER M , GUYADER V , DUGUE AE , MOURIAUX F
Published: November 2013

Purpose Like many mammal predators, Humans have frontal (forward‐facing) orbits. This design allows a large overlap of monocular visual fields with good stereoscopic vision but is considered to harm lateral space perception. In Humans, on average, temporal visual field extends 95° in primary position of gaze but 128° with eye abduction. Which anatomical peculiarity may allow such a visual field expansion?

Methods Comparative orbit osteology study in 100 human skulls and 120 Apes’ skulls (30 gibbons; 30 orang‐utans; 30 gorillas; 30 chimpanzees and bonobos). Orbit width and height were recorded. Using a protractor and laser levels two orbit angles were recorded: “convergence angle” (the lower this angle, the more frontal the inner orbital rim orientation) and “opening angle” (the higher this angle, the more backward the temporal orbital rim position).

Results The largest orbit width/height orbit ratio is 1.19, in Humans (p < 0.001). Humans have a higher “convergence angle” (98.1°) than all Apes except gibbons (99.2°; p > 0.05). Humans have by far the largest “opening angle” (107.1°; p < 0.001) and the largest difference between “opening angle” and “convergence angle” (9°; p < 0.001).

Conclusion The largest orbit width/height ratio found in Humans suggests a design that favours lateral vision. More specifically, human orbital rim is unique in that, while frontal, it has by far the most backward temporal orbital rim. This peculiarity ‐ likely and adaptation to terrestrial life with upright bipedal locomotion ‐ allows both good stereoscopic vision and large temporal visual field extent through eye motion.
Small molecule design strategy to overcome antibiotic resistance
Authors: BEUERMAN R
Published: November 2013

Purpose Although antimicrobial peptides have been shown to avert resistance, most small molecule antibiotics do not share that characteristic. Antimicrobial peptides though are often less stable environmentally and have difficult delivery problems. However, small molecules are much easier to develop from a pharmaceutical perspective. This study has combined the properties of antimicrobial peptides into a small molecule platform.

Methods Using our design platform which consists of microbiology, biophysical (including NMR), and animal data we have used the molecular backbone of a xanthone, alpha‐mangostin which is extracted from the pericarp of the SE Asian fruit, mangosteen. The xanthone is a heterocyclic planar molecule with sites at carbons 3 and 6 modifiable with amino acids or other functional groups. Stable, water soluble compounds have been developed whose activities are tested in vitro in microbiological assays as well as in mouse models of corneal infection. These molecules have been tested in MIC, time kill studies and in simulations of resistance.

Results The results show that the antimicrobial activities of the cationic xanthone derivatives can be generally predicted based on the pKa values of the corresponding amines. We have identified AM‐0016 (3b) as the most potent compound in the series with potent antimicrobial activity with MIC values of 0.095‐0.39 (µg/mL) against Gram‐positive bacteria including MRSA, improved selectivity up to 200, rapid time‐kill in 10‐30mins,

Conclusion A series of novel antimicrobials have been designed and prepared by cationic modifications of α‐mangostin, a natural xanthones with a planar hydrophobic core, to yield an amphiphilic structure which improves selectivity for bacterial membranes through the hydrophobic‐water interface perturbation.
Reduced Th17 type inflammation associated with enhanced Th1, Th2 and Treg responses in a model of reactivation of congenital ocular toxoplasmosis
Authors: SAUER A , BOURCIER T , CANDOLFI E , PFAFF AW
Published: November 2013

Purpose Ocular toxoplasmosis (OT) is a major cause of blindness in the world. Ocular involvement is frequently seen following congenital infection. Many of these infections are quiescent but pose a life‐time risk of reactivation. We previously developed a Swiss‐Webster outbred mouse model for congenital toxoplasmosis by neonatal injection of Toxoplasma gondii cysts. We also used a mouse model of direct intraocular infection to show a deleterious local Th17 type response upon primary infection. However, little is known about the physiopathology of reactivation.

Methods In the present study, we combined our two models to study reinfection into neonatally infected mice, in comparison with a primary ocular infection. Intraocular immunological determinants were studied using both BioPlex proteomic assays in aqueous humor and RT‐PCR for crucial transcription factors.

Results We observed diminished Th17 type reaction in reinfection, compared to primary infection. In contrast, Th2 and T regulatory responses were enhanced. Interestingly, this was also true for Th1 responses, which was paralleled by a better parasite control. We observed a similar protective immune reaction pattern in the eye upon reinfection with the virulent RH strain, with the notable exception of IFN‐γ.

Conclusion In summary, our results show a less pathogenic but more effective anti‐parasite pattern during reinfection.
New concepts of treatment for LHON and other genetic mitochondrial optic neuropathies
Authors: SADUN A
Published: November 2013

In Leber’s Hereditary Optic Neuropathy (LHON), complex I impairment can lead to subacute loss of vision and optic nerve atrophy, usually in young adulthood. This blockage of electron transfer produces some decrease in ATP production, but also a severe accumulation of reactive oxygen species (ROS) that is thought, at a critical threshold, to lead to RGC apoptosis. Co‐enzyme Q10, a quinone, has the potential to reroute the spilled electron, however treatment with co‐enzyme Q10 has been ineffective. Idebenone, a second generation quinone with better drug delivery characteristics, has demonstrated some efficacy in LHON (results presented in a companion presentation). EPI‐743 is a third generation quinone that has other promising characteristics. We provided EPI‐743 (300 mg, TID) in an open label trial to 12 patients with recent visual loss from LHON and carefully followed 23 eyes for 2‐3 years (16 to 40 months). Seven of 23 eyes demonstrated improvements in visual acuity and 5/23 improvements in HVF. Thirteen of 23 eyes showed improvements or at least acute stabilization of vision with these outcome measures. Oddly, the time to recovery was very long (9 to 15 months).

Commercial interest
The fate of the corneal endothelium during storage: apoptosis/necrosis/survival
Authors: ARMITAGE J
Published: November 2013

Cell death during corneal storage is, at least with current methods, inevitable. There are also concerns with a tissue such as cornea for the maintenance of cell‐cell and cell‐matrix interactions that are so vital for overall physiological function of the tissue. The reversibility of such changes is clearly of fundamental importance. However, once cells are committed down a pathway of cell death, there is perhaps little that can be done to reverse this process. The terminology applied to describe cell death perhaps clouds our perception and too easily leads us to categorize cell death simply as apoptosis or necrosis. In particular, the term necrosis merely describes an end point and sheds no light on the mechanism by which a cell died, for example by oncosis. Understanding the mechanisms and pathways to cell death may, however, provide insights into novel targets for supporting cells, reducing cell loss, and improving functional integrity.
Evaluation of the donor tissue during storage
Authors: BORDERIE V
Published: November 2013

Development of new surgical techniques for corneal transplantation induces major modifications in the graft selection process in eye banks. Quality of the donor corneal tissue must currently be assessed according to the scheduled surgical procedure. Not only the endothelial layer should be assessed by conventional techniques (trypan blue staining, light microscopy, specular microscopy) but also the corneal stroma and epithelium. This latter task requires development of new techniques such as high definition optical coherence tomography. Full field‐OCT, in providing a detailed study of corneal structures with ultrahigh resolution (1 µm in all directions), permits detecting corneal conditions that are currently difficult to identify in eye banks, such as keratoconus, absence of Bowman’s layer, or corneal scars. It permits evaluating precisely Descemet’s membrane condition. It seems to be a promising technique in complement to current assessment methods of human donor corneas. Proper evaluation of the donor tissue by the new technologies implies formation of the eye bank staff. The staff has to get close relationships with the surgeons and to be attentive to the special requirements related to the scheduled surgical technique.
Preparing donor tissue for DSEK
Authors: DICKMAN M
Published: November 2013

Donor tissue preparation remains a critical step in endothelial keratoplasty technique. Since its introduction in 2008 the use of pre‐cut grafts for Descemet stripping automated endothelial keratoplasty (DSAEK) has become increasingly popular. Pre‐cut tissue enables additional quality control, not readily available in the operating theater, shortens operation time, eliminates intraoperative donor related complications, overcomes surgeon’s learning curve associated with valuable donor tissue loss and allows surgeons who do not have the necessary equipment to perform the procedure. Previous reports suggesting thinner grafts may result in better visual outcomes have driven surgeons to either try and harvest ultra‐thin grafts themselves or request eye banks to do so for them. However, preparation of ultra‐thin grafts is not without challenges. In the current session the literature on the safety and efficacy of precut tissue for (ultra‐thin) DSAEK will be reviewed. The results of our in‐vitro studies on thickness reproducibility and endothelial cell viability of ultrathin precut tissue for DSAEK, using an innovative microkeratome system, as well as our preliminary clinical experience with these grafts will be presented.