bluuebunny/crossref_metadata_2025 huggingface dataset:
Conditioned Alterations of Specific Blood Leukocyte Subsets Are Reconditionable
Authors: Exton Michael S. , von Hörsten Stephan , Strubel Tim , Donath Stephan , Schedlowski Manfred , Westermann Jürgen
Published: April 2003

Behavioral conditioning has the ability to produce changes in immune function. However, it is unknown whether conditioned changes of immune function can be recalled on multiple occasions. To address this issue we paired a novel saccharin drinking solution with intraperitoneal cyclosporin A (CsA) injection in rats. Saccharin re-presentation produced a reduction in splenocyte proliferation that mirrored the effect of CsA. Such functional changes were paralleled by a significant conditioned leukopenia in peripheral blood, which opposed the leukocytosis induced by CsA. Using the conditioned leukopenia in blood as a ‘diagnostic window’ of conditioned immunosuppression, the maintenance of CsA-induced changes was investigated by examining blood samples collected repeatedly. Experiments on the same group of animals over a period of 1 year showed that the conditioned leukopenia was reproducible on multiple occasions by reimplementing either the whole conditioning paradigm or reexposure to the saccharin solution only. These results demonstrate that behaviorally conditioned alterations of immune parameters are maintained in subsequent trials, indicating the potential clinical feasibility of behavioral conditioning procedures.
Characterization of the Promoter-Directing Expression of Growth Hormone in a Monocyte Cell Line
Authors: Weigent Douglas A. , Vines Clifford R. , Long Jay C. , Blalock J. Edwin , Elton Terry S.
Published: April 2003

Previous work from our laboratory has shown that cells of the immune system produce a growth hormone (GH) molecule similar to that produced by the pituitary. In the present study, using Southern analysis of RT-PCR products and sequencing of cloned cDNA molecules, we demonstrate that lymphoid cell lines utilize the same promoter and first exon as the pituitary somatotrope. To identify the cis-elements involved in transcriptional regulation of immune cell-derived GH, we have coupled rat GH promoter fragments to a luciferase reporter gene and transfected a monocyte cell line (P-388) by electroporation. The results suggest the presence of both positive (–299/–193 bp) and negative (–193/–107 bp) regulatory elements. The same constructs transfected in the pituitary cell line, GH3, in contrast to the monocyte cell line, showed a gradual decrease in luciferase expression. The overexpression of GHF-1 or GHF-2 resulted in a modest but significant reduction in rat GH promoter activity in the P-388 cell line. Taken together, the data suggest that immune cells utilize the same first exon and promoter sequence for the expression of monocyte GH as that reported for the expression of pituitary GH. Further, it appears that sequences between –299 and –107 bp are important in the regulation of the promoter where different transcription factors may be recruited to promote GH expression in a monocyte cell line.
Natural Killer Cell Activity and Resistance to Tumor Metastasis in Prepubescent Rats: Deficient Baselines, but Invulnerability to Stress and β-Adrenergic Stimulation
Authors: Giboney Page Gayle , Ben-Eliyahu Shamgar
Published: April 2003

Although young children and animals exhibit high rates of tumor development, little is known about natural killer (NK) cell activity in the very young. We recently provided direct evidence that reduced levels of NK activity in prepubescent rats underlie higher levels of susceptibility to metastasis. The aim of the current study was to further characterize NK activity and tumor resistance in prepubescent rats, specifically with respect to the effects of stress and sex, as these factors have been shown to modulate tumor development in adult populations. Two NK outcomes were assessed: levels of whole blood NK cytotoxicity and lung tumor retention of NK-sensitive MADB106 tumor cells which metastasize only to the lungs. The corticosterone (CS) response to surgery was also assessed. In the first set of experiments, prepubescent males and females (36 days of age) and mature males (98 days) were subjected to abdominal surgery and 5 h later were either tested for plasma CS levels or challenged with MADB106 tumor cells. The findings indicated that whereas surgery increased CS levels in the young rats to similar levels observed in mature animals, surgical stress did not increase lung tumor retention in the young animals, despite exerting marked and significant effects in the mature rats. These findings persisted when lower tumor loads were used in the young rats to compensate for the markedly reduced resistance to metastasis in this population. Because surgery involves activation of the sympathetic nervous system (SNS) which is known to regulate NK activity, we assessed the impact of the β-adrenergic agonist, metaproterenol, on NK activity and on lung tumor retention. Metaproterenol (0.8 mg/kg, 1 h before testing) resulted in a large suppression of NK activity and resistance against MADB106 metastasis in mature males and females, but not in prepubescent animals. In mature, but not in young animals, males exhibited higher baseline levels of NK activity. Taken together, these findings indicate that NK cells of prepubescent rats are resistant to β-adrenergic stimulation, and suggest that prepubescent rats are markedly less responsive to SNS-induced suppression of NK activity, which may underlie their invulnerability to the effects of surgery on MADB106 metastasis.
Serum Neopterin and Somatization in Women with Chemical Intolerance, Depressives, and Normals
Authors: Bell Iris R. , Patarca Roberto , Baldwin Carol M. , Klimas Nancy G. , Schwartz Gary E.R. , Hardin Elizabeth E.
Published: April 2003

The symptom of intolerance to low levels of environmental chemicals (CI, chemical intolerance) is a feature of several controversial polysymptomatic conditions that overlap symptomatically with depression and somatization, i.e., chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity, and Persian Gulf syndrome. These syndromes can involve many somatic symptoms consistent with possible inflammation. Immunological or neurogenic triggering might account for such inflammation. Serum neopterin, which has an inverse relationship with l-tryptophan availability, may offer a marker of inflammation and macrophage/monocyte activation. This study compared middle-aged women with CI (who had high levels of affective distress; n = 14), depressives without CI (n = 10), and normals (n = 11). Groups did not differ in 4 p.m. resting levels of serum neopterin. However, the CI alone had strong positive correlations between neopterin and all of the scales measuring somatization. These preliminary findings suggest the need for additional research on biological correlates of ‘unexplained’ multiple somatic symptoms in subtypes of apparent somatizing disorders.
New Antiepileptic Drugs in Epileptology
Authors: Elger Christian , Bauer Jürgen
Published: April 2003

New antiepileptic drugs have been developed and released for the treatment of chronic focal and secondarily generalized epileptic seizures. The anticonvulsant efficacy of these drugs (vigabatrin, lamotrigine, gabapentin, felbamate, tiagabine, topiramate and oxcarbazepine) does not seem to be superior to that of traditional anticonvulsants. The main advantage of these newly developed drugs is a different spectrum of possible adverse events (i.e. these drugs usually do not induce sedation). Moreover, interactions with traditional anticonvulsants are less common, therefore, comedication with these drugs shows an improved tolerability. The availability of new antiepileptic drugs enables us to establish an individually tailored anticonvulsant strategy for each patient.
Effects of Fentanyl and Low Doses of Alcohol on Neuropsychological Performance in Healthy Subjects
Authors: Schneider Udo , Bevilacqua Carmine , Jacobs Roland , Karst Matthias , Dietrich Detlef E. , Becker Hinnerk , Müller-Vahl Kirsten R. , Seeland Irina , Gielsdorf Dirk , Schedlowski Manfred , Emrich Hinderk M.
Published: April 2003

The effects of the opioid fentanyl and low doses of alcohol on neuropsychological functions in healthy volunteers were measured. Twenty-four healthy male volunteers participated in this study. Two randomised placebo-controlled cross-over trials were conducted. In group 1, 6 subjects received fentanyl (0.2 µg/kg body weight) in the order of fentanyl/placebo and 6 subjects in the order of placebo/fentanyl. Group 2 received alcohol in a similar procedure by continuous intravenous infusion, leading to a blood alcohol concentration (BAC) of 0.03%. Impairment was measured via different neuropsychological tests. The results indicate that fentanyl in concentrations commonly used in out-patient surgical procedures produces pronounced cognitive impairment (auditory reaction time, signal detection, sustained attention, recognition) in comparison to placebo. After application of low doses of alcohol (BAC 0.03%) only visual reaction time was impaired in comparison to placebo.
Incidence and Risk Factors of Benign Creatine Phosphokinase Elevations in Chronic Psychiatric Patients
Authors: Terao Takeshi , Matsuda Shinya , Kojima Hideki , Okuno Kanae , Hori Hiroko , Kaku Akiko , Ueda Nobuhisa , Etoh Akira
Published: April 2003

There have been few studies focusing on the creatine phosphokinase (CPK) elevations in chronic psychiatric patients. The survey was conducted prospectively to investigate the incidence and risk factors of CPK elevations in chronic psychiatric patients during a 2-year follow-up period. Sixteen of 32 (50%) patients had maximums of more than 230 U/l (upper limit of our normal range) and 7 (22%) patients had maximums of more than 500 U/l. Surprisingly, 4 (13%) patients had maximums of more than 1,000 U/l after exercises such as swimming and walking. Nonetheless, none of the 16 patients with the CPK elevations developed severe conditions such as rhabdomyolysis despite an absence of therapeutic intervention, and their CPK elevations were proven to be benign. According to the path analysis, usual physical activity and neuroleptic doses seemed to underlie CPK elevations directly. The present findings suggest that not a few chronic psychiatric inpatients may have at least one CPK elevation per 2 years. Patients engaging in more physical activity or receiving higher neuroleptic doses are at greater risk of developing such CPK elevations. However, most of these increases are benign, and it is not considered necessary to treat them.
Schizophrenia – A Disturbance of Signal Interaction between the Entorhinal Cortex and the Dentate Gyrus? The Contribution of Experimental Dibenamine Psychosis to the Pathogenesis of Schizophrenia: A Hypothesis
Authors: Arnold Ottokar Hans
Published: April 2003

In addition to the existence of complex memory (similar to the implicit nondeclarative memory of Squire), the existence of a phylogenetically old apparatus of a memory of situations (SMA) is supposed, which is to some extent comparable with the declarative memory of Squire. During actual sensory information the SMA generates a general frame and forms a general ‘mark’, indicating whether a given information has its origin inside or outside the body, and whether it is new or known. The procedure of this marking process can be explained as the time-depending arrest of a copy of the actual original information-transporting signal ‘shower’; this copy must last until the feedback from thalamocortical centers indicates the termination of the processing of the original signal showers. The arrest of the shower copies is the performance of neuronal networks of the entorhinal cortex (EC) and the gyrus dentatus (GD). The psychopathological and biochemical analyses of experimental dibenamine psychosis show a different effect of dibenamine on the noradrenaline (NA) receptors of the EC and GD, respectively: these effects are responsible for the repeated perception cycles of a single situation. N,N-Dibencylamine blocks the postsynaptic α1-receptors of the EC without influencing the β-receptors of the GD. Thus the interaction between EC and GD is changed: instead of new scenes, perceptions that have just been experienced get repeated presence and the quality of familiarity. The prolonged arrest of shower copies simultaneously blocks the entrance of new signal showers from the EC to the GD. No information-transporting signal showers can come in as long as the arrest lasts. In case of a disturbance in NA-dependent actions within the EC and the GD, the duration of arrest of information-transporting signal showers is shortened. Thus the formal frame of experience receives the quality of novelty instead of familiarity, and in addition the qualities of uncertainty, vagueness, and alienity. These very changes in perception and experience represent the basic disturbance of schizophrenia. All the symptoms of schizophrenia may be explained by this basic disturbance. The analysis of biochemical aspects turns attention to the energetic situation of NA and N-methly-d-aspartate systems. These considerations suggest a genetic background of the basic disturbance of schizophrenia: transmitter effects on membranes of neurons and possibly also on glial cells, and energy supply of these effects may be predetermined genetically. It may be assumed that the compensation of such membrane-dependent disturbances will be possible within wide areas of the neural network, except for the ‘bottleneck’ of the overlapping region of the iso- and allocortex.
No Association between Alpha-1-Antichymotrypsin Polymorphism and Alzheimer’s Disease in Chinese
Authors: Wang Ying-Chieh , Liu Tsung-Yun , Liu Hsiu-Chih , Chi Chin-Wen , Sim Cho-Boon , Tsai Shih-Jen , Hong Chen-Jee
Published: April 2003

A recent observation has shown that a common polymorphism in the α1-antichymotrypsin (ACT) confers a significant risk for Alzheimer’s disease (AD). Furthermore, the apolipoprotein E ε4 allele (APOE*4) effect associated with AD risk is modified by the ACT polymorphisms. To evaluate the role of ACT polymorphism in AD, we conducted an association study of ACT polymorphisms in Chinese AD patients and normal controls. We found that the ACT polymorphism had no effect on the development of AD either alone or in combination with the APOE*4 allele.
Plasma Concentration and CNS Effects of Ca Antagonists Darodipine and Nimodipine after Single-Dose Oral Administration to Healthy Volunteers
Authors: Sannita W.G. , Garbarino S. , Gesino D. , Massimilla S. , Ogliastro C.
Published: April 2003

The dynamics at the brain level (quantitative EEG), plasma kinetics and effects on blood pressure and heart rate of the Ca antagonists, darodipine (slow-release, 50– 200 mg) and nimodipine (30 mg), were compared in a double-blind cross-over study on healthy volunteers during a 9-hour period following single drug/placebo administration. Increased EEG total power was observed after 100 and 200 mg daropidine; a concomitant decrease of 14.5–32.0 Hz relative power was observed at 100 mg. The 50-mg dose proved ineffective. These effects were correlated with the darodipine plasma concentration only at the 100-mg dose, with indications of an active concentration interval at approximately 5–10 ng/ml; a reduction in diastolic blood pressure and increased heart rate proved to be linearly correlated with the drug plasma concentration throughout the entire concentration range. Comparable EEG effects were observed after nimodipine, but they did not correlate with the plasma concentration. Implications of the predictability of the brain effect from the drug plasma concentration and differential thresholds for the brain action and effects on (peripheral) circulation are suggested.
Six Basic Dimensions of Personality and a Seventh Factor of Generalized Dysfunctional Personality: A Diathesis System Covering all Personality Disorders
Authors: Andresen Burghard
Published: April 2003

The five-factor model (FFM) of personality has recently been claimed to be comprehensive for all dimensionally conceived personality disorders (PDs). This assumption is refuted on the grounds of a principal component analysis conducted for three basic factor inventories (FFPI, NEO-FFI, Hamburg Personality Inventory), 22 explorative facet scales for normal personality and a questionnaire inventory (Inventory of Clinical Personality Accentuations) of 24 PD scales. Seven substantial orthogonal Varimax factors were found explaining 73% of the total variance. The five factors of the FFM were replicated. In addition, a new basic factor ‘risk and competition seeking’ (basic dimension ‘risk’, BD-R) emerged replicating findings of Andresen. The massive seventh factor was substantially loaded by all 24 PD scales and interpreted as ‘general dysfunctional personality’ (GDP). Most of the highly loaded scales describe varying forms of cognitive aberration. Together with GDP, the six-factor model now explains about 73% of all PD scales, thus, a virtually comprehensive descriptive diathesis system is achieved. Without GDP and BD-R, only 25% can be accounted for by the FFM. Five of the six normal dimensions will be loaded with positive and negative signs by some PDs. Neuroticism (BD-N) is still unique regarding its positive substantial correlations with almost all PD scales. BD-N is also the only normal factor which is correlated with GDP at about 0.50. A geometric model for the relationships between basic and clinical factors is presented.
Influence of Method on Seasonal Distribution of Attempted Suicides in Italy
Authors: Preti Antonio , Miotto Paola
Published: April 2003

To verify if attempted suicides follow different seasonal distributions according to the method chosen, we studied the Italian monthly distribution of admissions for attempted suicide in the period 1984–1995 according to gender and age, distinguishing between non-violent (ICD 950–952) and violent (ICD 953–958) attempted suicides. The effect of temperature was also taken into account. A clear asymmetry in seasonal distribution of events can be observed in the oldest age groups in both genders, with a peak in warmer months. Only male attempted suicides by violent methods show a clear asymmetry in seasonal distribution, with a peak in spring months and a trough in autumn months. Spectral analysis, more accurate in detecting seasonal rhythms than analyses that only compare monthly seasonal means, identifies a circannual rhythm for violent suicides in both genders. The seasonal components of total variance in attempted suicides account for 16.5 and 12.4%, respectively, of violent male and female attempted suicides. Among males, a significant (p < 0.05) 4 cycles/year pattern is seen alongside the more relevant (89.4%, p < 0.01) 1 cycle/year distribution. Among females, aside from the 1 cycle/year distribution (63.3%, p < 0.01) noted, a 6 cycles/year pattern is found to contribute significantly (16.9%, p < 0.05) to the seasonal component of variance. A clear relationship with temperature indicators is noted among males: higher temperatures positively correlate with attempted suicides, whereas cooler temperatures seem to exert a protective action. Female attempts show a less evident correlation with indicators of temperature. Sample composition by age and gender and the lack of distinction between methods of attempted suicide may have obscured the seasonal component of some classes of attempted suicide in previous studies. The circannual rhythm found in this study of violent attempted suicide in relation to climate seasonal change confirms the importance of taking chronobiological variables into account in the evaluation of patients at risk of suicide.
The Control of Blepharospasm by Essential Fatty Acids
Authors: Mostofsky David I. , Yehuda Shlomo , Rabinovitz Sharon , Carasso Ralph
Published: April 2003

Dopamine depletion induced by administration of Ro4-1284 produces a condition of rapid and repeated eye blinking in rats. This condition mimics the human disorder, blepharospasm, which often accompanies parkinsonism and other dopamine deficiency disorders. When given a 3-week course of a compound (SR-3) developed from a specific ratio of two free polyunsaturated fatty acids – linoleic acid and α-linolenic acid – the eye blinking rate following administration of Ro4-1284 is reduced to saline and no drug control levels. These results suggest a favorable prospect for essential fatty acids in general, and SR-3 in particular, to provide an improved therapeutic option for the clinical management of benign essential blepharospasm.
Quantitative EEG in Schizophrenic Patients before and during Pharmacotherapy
Authors: Begić Dražen , Hotujac Ljubomir , Jokić-Begić Nataša
Published: April 2003

The aim of the study was to determine the possible differences in quantitative EEG parameters of schizophrenic patients before and during therapy with neuroleptics. First EEG recordings were obtained from schizophrenic patients (n = 50) who had not been taking any medicaments during the preceding 2 months. Second EEG recordings were obtained during the administration of neuroleptic therapy. Amplitude values of particular spectral segment, i.e. delta, theta, alpha 1, alpha 2, beta 1 and beta 2 (after fast Fourier transformation) were analyzed. The F3, F4, C3, C4, T3, T4, P3, P4, O1 and O2 regions were observed. The effect of pharmacotherapy manifested as a decrease in delta and beta 2 activities. The alterations of the delta spectrum were recorded in each patient subgroup (regardless of the neuroleptic used). The changes in beta 2 activity were registered in patients on haloperidol and fluphenazine.
Apolipoprotein E ε3 Allele Is Not a Risk Factor of Schizophrenia: A Study of 314 Japanese Patients
Authors: Kimura Takemi , Shono Masahiro , Yokota Shuzo , Igata-Yi Ruriko , Takamatsu Junichi , Miyakawa Taihei
Published: April 2003

The association between apolipoprotein E (ApoE) alleles and schizophrenia has remained controversial. A recent report claiming that ApoE ε3 Taiwan Chinese carriers have an increased risk of schizophrenia prompted us to investigate the allele frequency in a large group of Japanese schizophrenic patients. Serum samples were obtained from 314 schizophrenic patients and 188 controls in Japan and examined using isoelectric focusing/immunoblotting. There were no significant differences in ApoE allele frequencies between schizophrenic patients and controls and in the odds ratios for schizophrenia among the ε2, ε3 and ε4 carriers. In contrast to the report from Taiwan, our findings and results of the majority of previous studies suggest no effects of ApoE alleles on the development of schizophrenia.
Neuroendocrine Responses to Psychological Stress in Adolescents with Anxiety Disorder
Authors: Gerra G. , Zaimovic A. , Zambelli U. , Timpano M. , Reali N. , Bernasconi S. , Brambilla F.
Published: April 2003

Neurotransmitter-neuroendocrine and cardiovascular responses to the administration of a psychologically stressful mixed-model test (Mental Arithmetic, Stroop Color Word Interference Task, Trier Social Stress Test) were examined in 20 male peripubertal subjects affected by anxiety disorder (group A: 14 with generalized anxiety disorder, 6 with generalized anxiety disorder and separation anxiety disorder) and 20 junior school adolescents, matched for age, without overt psychological disorders (group B). Plasma levels of norepinephrine (NE), epinephrine (EPI), adrenocorticotropic hormone (ACTH), β-endorphin (β-EP), cortisol (CORT), growth hormone (GH), prolactin (PRL) and testosterone (Te) were measured immediately before the beginning of the tests and 30 min later at their end. Mean prestress values of GH, PRL, β-EP and ACTH were significantly higher in anxious subjects than in controls. There was no difference in NE, EPI, CORT and Te prestress levels in the two groups. After the psychological stress session NE, GH and Te concentrations increased significantly in anxious subjects (A), but not in controls. In contrast, β-EP and PRL decreased significantly during the psychological stress session in anxious subjects, and were unaffected by stress in the subjects without anxiety. No significant changes were found in ACTH, CORT and EPI during the challenge either in anxious subjects or in controls, which may be attributed to the late time of poststress blood sampling. In contrast to controls, heart rate and systolic blood pressure increased significantly in anxious subjects after psychological stress testing. Our data support the hypothesis that the hyperactivity of the noradrenergic system in response to stress is associated with anxiety disorders in adolescents and might influence the responses of GH and Te. High prestress basal values of stress hormones seem to be induced in anxious subjects by the anticipation of the task or by a persistent hyperactivity of the noradrenergic system. Further studies are needed to investigate in more detail the involvement of the HPA axis in anxious adolescents by a more refined resolution of time points of blood sampling.
Effects of Diazepam on Auditory Evoked Potentials of Rats Elicited in a Ten-Tone Paradigm
Authors: Jongsma Marijtje L.A. , van Rijn Clementina M. , van Schaijk Willie J. , Coenen Anton M.L.
Published: April 2003

The effect of diazepam on sensory gating was studied in rats by measuring diazepam effects on auditory evoked potentials (AEPs) elicited in a ten-tone paradigm. Trains of 10 repetitive tone-pip stimuli were presented. Rats (n = 8) received 4 mg·kg–1 diazepam subcutaneously or vehicle, counterbalanced over two sessions. Diazepam decreased the amplitude of the middle-latency P30 component and increased the amplitudes of the late-latency N60 and P67 components. The increase in the late-latency components might be due to a diazepam-induced decrease in arousal. Stimulus repetition decreased the amplitudes of the middle-latency N18 and P30 components in both conditions. This suggests that automated neuronal recovery functions underlying sensory gating remain intact with diazepam. In the vehicle condition, the amplitude of the late-latency P67 decreased with stimulus repetition, but not in the diazepam condition. This suggests a diazepam-induced decrease of behaviourally mediated habituation.
Association Study of Apolipoprotein Eε4with Clinical Phenotype and Clozapine Response in Schizophrenia
Authors: Hong Chen-Jee , Yu Younger W.-Y. , Lin Ching-Hua , Song Hsiu-Li , Lai Hao-Che , Yang Kuan-Hung , Tsai Shih-Jen
Published: April 2003

Schizophrenic patients with the apolipoprotein E (APOE = gene; apoE = protein) ε4 allele exhibited lower psychosis scores than patients without the ε4 allele in previous reports. The present study tested the hypothesis that the APOE ε4 allele confers association with the clinical manifestations of schizophrenia or clozapine response. A total of 95 schizophrenic patients who were treatment resistant were included in the study. The results demonstrated that the presence of the APOE ε4 allele did not influence the response to clozapine in schizophrenic patients, neither was the baseline psychopathology related to the APOE ε4 allele. Given the multiple functions of the apoE protein in the brain, further study of the influence of APOE on CNS medication response is needed.
Lacrimal Immunoglobulins in Rheumatoid Arthritis Patients with or without Sjögren’s Syndrome
Authors: Domingo Isabel , Coll Joaquin , Ribas-Montobio Juan , Marrugat Jaime , Rubiés-Prat Juan
Published: April 2003

The aim of the present study was to analyse immunoglobulin G, A, and M levels in tears of patients with rheumatoid arthritis with or without keratoconjunctivitis sicca (KS) which define Sjögren’s syndrome (SS). Tears were collected from the lower cul-de-sac by capillarity (100–300 μl). Tear IgG, IgA and IgM levels were determined by radial immunodiffusion. Samples diluted 1:10 were used for IgA and IgG and non-diluted ones for IgM. Fifty-three patients with rheumatoid arthritis and 30 healthy control subjects were studied. In all individuals IgA predominated in tears, IgG levels were low but with a very wide range and IgM was present in very low concentrations. The IgG concentration in tears showed statistically significant differences between the control group and that of rheumatoid arthritis and KS. IgG in tears correlated positively with the rose bengal test (r = 0.2848, p < 0.05) and negatively with the Schirmer test (r = –0.3042, p < 0.05). Tear IgG measurement might provide a marker for eye involvement in patients with rheumatoid arthritis and KS which define SS.
Progression of Choroidal Atrophy in Acute Posterior Multifocal Placoid Pigment Epitheliopathy
Authors: Daniele Salvatore , Daniele Claudia , Orcidi Fabrizio , Tavano Antonio
Published: April 2003

Acute posterior multifocal placoid pigment epitheliopathy is a non-granulomatous chorioretinitis of uncertain origin that occurs in healthy young adults. The prevailing opinion is that the disease has a good long-term prognosis for visual acuity because it is self-limiting and chorioretinal scars do not enlarge with time. A middle-aged adult male who had acute posterior multifocal placoid pigment epitheliopathy in one eye has been followed for 22 years. After apparent clinical healing of the placoid epithelial lesions, widespread severe choroidal atrophy with visual loss occurred and progressed over years without interruption. To our knowledge this is the second report of progressive deterioration of a supposedly self-limiting chorioretinal disease.
Effect of Carbogen, Oxygen and Intraocular Pressure on Heidelberg Retina Flowmeter Parameter ‘Flow’ Measured at the Papilla
Authors: Lietz Andrea , Hendrickson Phillip , Flammer Josef , Orgül Selim , Haefliger Ivan O.
Published: April 2003

The aim of the study was to evaluate whether the Heidelberg retina flowmeter (HRF), a new device for retinal and anterior optic nerve blood flow assessment, can gauge, at least semiquantitatively, a known effect such as an increase in optic nerve blood flow by hypercapnia or a decrease in optic nerve blood flow by hyperoxia or high intraocular pressure (IOP). Measurements with the HRF were obtained at the papilla of three groups of 5 young healthy subjects (1) at baseline and after breathing 5% carbogen, (2) at baseline and after breathing 100% oxygen and (3) at baseline and after increasing IOP to 20 and 50 mm Hg. The changes in the value of the HRF parameter ‘flow’ were analyzed by means of a paired Student’s t test. Breathing 100% oxygen for 7 min resulted in a statistically significant decrease of 34.7±2.5% (mean ± SEM) in HR parameter ‘flow’ (p < 0.01) at the papilla. Breathing 5% carbogen for 7 min resulted in a statistically significant increase of 18.3±2.6% in HRF parameter ‘flow’ (p = 0.024). Increasing IOP to 20 mm Hg did not result in a statistically significant change in HRF parameter ‘flow’ (–9.6±7.4%; p = 0.13). Increasing IOP from 20 to 50 mm Hg, however, resulted in a statistically significant decrease of 40.1±6.6% in HRF parameter ‘flow’ (p = 0.003). With the applied stimuli, the HRF parameter ‘flow’ changed in the expected direction, i.e. an increase with hypercapnia and a decrease with hyperoxia or high IOP. The simplicity of use of the HRF instrument suggests that it might be well suited for a non-invasive, at least semiquantitative, assessment of changes in blood flow at the papilla.
The SRKII Formula in the Calculation of Intraocular Lens Power
Authors: Nurözler Ayse , Ünlü Nurten , Yalvaç Ilgaz  Sagdiç , Kasim Remzi , Duman Sunay
Published: April 2003

This study compares the predictive accuracy of the SRKII formula for groups with average axial length and long eyes. 344 eyes which underwent cataract extraction with implantation of a posterior-chamber intraocular lens were included in the survey; 246 eyes had an average axial length (22.0–24.49 mm), and 98 eyes had an axial length of more than 24.50 mm. Mean absolute errors were 0.26±0.68 dpt in the first group and 1.16±1.78 dpt in the second group. 94.3% of the average eyes were within 1.0 dpt of the expected refraction, 98.8% within 2.0 dpt, whereas in the long-eye group 58.2% were within 1.0 dpt and 84.7% within 2.0 dpt. The results show that the SRKII formula performed credibly in average-length eyes; in the long eyes the ratio of large refractive deviations was greater than that of the other group.
Compressive Lesions of the Abducens Nerve in the Subarachnoid Space Disclosed by Thin-Slice Magnetic Resonance Imaging
Authors: Hashimoto Masato , Ohtsuka Kenji
Published: April 2003

We evaluated the usefulness of thin-slice magnetic resonance (MR) imaging as a tool for diagnosing compressive lesions of the abducens nerve in the subarachnoid space. We performed thin-slice MR imaging of the brain stem in two patients with abducens nerve palsy. Thin-slice MR images showed the abducens nerves in the subarachnoid space and clearly showed compressive lesions of the nerves by a brain tumor in both cases. These findings suggest that thin-slice MR imaging is useful for the evaluation of compressive lesions of the abducens nerve in the subarachnoid space.
Bilateral Malignant Melanoma of the Choroid in the United States
Authors: Ruiz Richard S. , El-Harazi Sherif M. , Kellaway Judianne
Published: April 2003

We examined a 73-year-old woman with bilateral malignant melanoma of the choroid associated with multiple nonocular malignancies. Fine-needle aspiration biopsy was performed in the left eye to provide a tissue diagnosis. Cytologic examination of the lesion in the left eye confirmed the diagnosis of primary malignant choroidal melanoma. This case demonstrates that bilateral malignant melanoma of the choroid occurs more frequently than expected, and may be associated with nonocular malignancies.
Nonproliferative Diabetic Retinopathy – Reflection Spectra of the Macula before and after Laser Photocoagulation
Authors: Augsten Regine , Königsdörffer Ekkehart , Schweitzer Dietrich , Strobel Jürgen
Published: April 2003

This study examines the influence of diabetic and laser photocoagulation on the reflection spectra of the macula. In the investigation 43 patients with type II diabetes mellitus and 33 normals were included. It was shown that the optical density in diabetics is increased compared to normals. After laser photocoagulation the reflection spectra have changed, suggesting a decrease in optical density. It is proposed that the therapeutic effect of photocoagulation in diabetic retinopathy is related to an alteration in blood flow in the choroid.
Fluctuations of Intraocular Pressure during the Day in Open-Angle Glaucoma, Normal-Tension Glaucoma and Normal Subjects
Authors: Saccà Sergio  Claudio , Rolando Maurizio , Marletta Antonio , Macrì Angelo , Cerqueti Piera , Ciurlo Giuseppe
Published: April 2003

Purpose: The aim of the present paper is to describe the variations in intraocular pressure (IOP) during the day in normals, in patients with primary open-angle glaucoma (POAG) and in patients with normal-tension glaucoma (NTG). IOP represents one of the most important risk factors for glaucoma. However the IOP value is not constant during the day and IOP fluctuation could influence the diagnostic and prognostic evaluation of the glaucomatous disease. Methods: For this purpose IOP was evaluated every 2 h from 8 a.m. to 8 p.m. in one randomized eye of 33 normal subjects, 95 POAG and 50 NTG patients. Results: The results show that the highest IOP values were detectable in the morning in all three groups. The lowest values were found in the early afternoon hours. These variations were most evident in POAG patients. The daily IOP fluctuations were directly proportional to IOP level. Conclusion: The study evidents that a single tonometric evaluation, especially if done in the first hours of the afternoon, is not sufficient to correctly evaluate the IOP-related risk in glaucoma patients. If the pressure peaks are important in determining the extent of glaucomatous damage in NTG patients IOP should not have an important role in optic nerve head damage. The use of diurnal curves seems to be mandatory for the assessment of IOP-related risk and of efficiency of the therapeutic approach.
Diode Array as Fixation Light to Reduce Unwanted Globe Movements
Authors: Frohn Andreas , Thiel Hans-Jürgen
Published: April 2003

In ocular surgery complications can occur from eye movements during topical anesthesia or insufficient retrobulbar anesthesia. To minimize eye movements during surgery a fixation light was designed consisting of a diode array embedded in an eye patch, and a keyboard, which will be positioned on the patient’s thorax. The patient focuses with the unoperated eye at a flashing diode which is part of the diode array. The operated eye is guided by conjugated eye movements. With the keyboard, the surgeon can change the diode signal all over the array. As a result, the eye is kept still or moved in the appropriate direction to facilitate the surgical process. The flat and lightweight design of the device enables its use under sterile surgical covers or in an upright position of the patient during laser applications.
The Protection of the Retina from Ischemic Injury by the Free Radical Scavenger EGb 761 and Zinc in the Cat Retina
Authors: Kim Si-Yeol , Kwak Jung-Sik , Shin Jae-Pil , Lee Sang-Hee
Published: April 2003

We investigated the effects of a free radical scavenger (EGb 761) and zinc in experimentally induced ischemic injury in the cat retina. Total retinal ischemia for 90 min was produced in the left eyes of 40 cats by raising intraocular pressure. In group 1, 10 cats were used as control. The free radical scavenger (EGb 761, 100 mg/kg) in group 2 (10 cats) and zinc chloride (250 μg/kg) in group 3 (10 cats) were administered intravenously at the end of ischemia. In group 4, both EGb 761 (100 mg/kg) and zinc chloride (250 μg/kg) were injected into 10 cats. ERG and a histologic study were performed 1 h, 1 day, 3 days, 1 week and 2 weeks after ischemia. The amplitude of the ERG b-wave was 62.73±0.32, 84.31±6.10, 83.65±12.23 and 102.4±14.27%, and the summed amplitude of oscillatory potentials was 66.16±16.42, 99.44±14.92, 95.45±6.42 and 99.62±12.32% in each group 2 weeks after ischemia. There was no significant effect in animals that received zinc alone (group 3) by the end of 1 week but some additive effect in combining EGb 761 and zinc chloride (group 4) 1 h after ischemia. These findings suggest that the free radical scavenger EGb 761 may efficiently protect the retina from ischemic injury and zinc may have an additive effect when combined with a radical scavenger.
Indocyanine Green Angiography in Age-Related Macular Degeneration with Occult Neovascularization
Authors: Pece Alfredo , Introini Ugo , Bolognesi Gianluigi , Brancato Rosario
Published: April 2003

This study has been conducted to assess the sensitivity of indocyanine green angiography (ICGA) in detecting choroidal neovascularization (CNV) in patients with age-related macular degeneration (ARMD) with occult CNV at fluorescein angiography (FA) and to establish their eligibility for laser photocoagulation. Three hundred eighty-three eyes of 355 consecutive patients with occult CNV at FA were studied by ICGA; occult CNV with or without pigment epithelial detachment (PED) were detected as well. Eligibility for laser treatment was established on the basis of the ICGA-guided CNV extension and localization. Out of 157 eyes (41%) with occult CNV and PED, 74 (47.1%) showed focal ICGA CNV, 35 eyes (22.3%) had plaque CNV. Thirty-five eyes with PED (22.3%) appeared serous without CNV, and in 13 eyes (8.3%) no CNV was detectable because of large hemorrhages. Out of the 226 eyes (59%) presenting occult CNV without PED, 94 eyes (41.6%) had plaque CNV, and 58 (25.7%) had focal CNV. In 74 eyes (32.7%), there was no detectable CNV or only an ill-defined ICGA appearance. ARMD with PED is closely associated with focal CNV, while plaque CNV is largely found in exudative ARMD without PED (p < 0.001). Considering all the cases examined by ICGA, CNV was evident in 261 eyes (68%) occult at FA. Extrafoveal CNV laser treatment was recommended for 103 eyes (27%). Our results suggest that ICGA may be useful in the diagnosis and management of ARMD with occult CNV at FA increasing the number of patients eligible for laser treatment.
Phacotrabeculectomy with a Small-Optic PMMA Implant: Two-Year Functional and Morphological Results
Authors: Menapace Rupert , Wedrich Andreas , Mühlbauer-Ries Eva , Strenn Karin , Vass Clemens
Published: April 2003

Purpose: Previous studies have documented good pressure control with combined cataract and filtering surgery. However, relatively high incidences of iridocapsular synechiae (ICS) and cell precipitates on the optic (CPO) were found. Corneal valve incisions preclude intraoperative chamber flattening and iris injury or prolapse. Rigid one-piece PMMA lenses with a small optic maintain a pronounced optic-iris clearance. In a prospective series, the effect of this approach was studied with special regard to the morphological results. Methods: A temporary corneal lip was created in the clear cornea beneath the scleral flap to serve as a temporary valve during cataract extraction. The lip was then widened and a rigid one-piece 5-mm PMMA lens implanted. Lip and trabeculum were finally excised en bloc at a width of 3 mm. Two years’ functional and morphological results were evaluated. Results: Fifty-four eyes were available for evaluation. After the mean follow-up of 21 months, mean IOP had dropped from 21.6±3 mm Hg preoperatively to 13.9±2.4 mm Hg, with a mean pressure reduction of 7.7±3.4 mm Hg. IOP was 18 mm Hg or less in all cases. The mean medication index dropped from 2.7 to 1.0. Eyes with a preoperative IOP of 21 mm Hg or more showed a significantly greater IOP reduction than eyes with an IOP of 20 mm Hg or less (–9.2±3.0 vs. –6.1±2.9 mm Hg, p = 0.0003). Intraoperatively, the temporary valve effectively prevented chamber flattening and iris injury or prolapse. Postoperatively, 9 eyes or 6% showed hyphemas, 1 undergoing lavage. Two eyes developed a capsular hematoma, 1 requiring YAG capsulotomy. Ten eyes or 19% developed mild and 2 eyes severe but transient fibrin exudation following hypotony or iridoplasty. One eye showed grade I anterior chamber flattening, 1 developed a ciliolenticular block requiring surgery. Postoperative pressure spikes of 30–35 mm Hg were noted in 4 eyes. Three eyes showed prolonged hypotony associated with transient choroidal effusion. A pronounced optic-iris clearance was found in 87% of the eyes. Iris-optic touch developed in 1 eye with prolonged postoperative anterior chamber flattening and in 3 of the 4 eyes that had undergone intraoperative iridoplasty. Three of the latter developed extensive ICS followed by CPO. The mean optic-iris distance was 1.2 mm and the anterior chamber depth 4.2 mm. Conclusion: Apart from effectively lowering IOP, the surgical approach used significantly reduced the incidence of ICS and CPO.
Corneal Sensitivity Changes in Long-Term Wearing of Hard Polymethylmethacrylate Contact Lenses
Authors: Sanaty Mujgan , Temel Ahmet
Published: April 2003

The effect on corneal sensitivity of years of wearing hard contact lenses was evaluated in 20 subjects who had worn polymethylmethacrylate (PMMA) lenses for up to 20 years. An age- and sex-matched group of 20 eyes was used as the control group. It was found that corneal sensitivity diminished significantly in wearers of PMMA contact lenses. This reduction of corneal sensitivity was found to be most prominent centrally and was markedly related with the duration of PMMA contact lens use. The loss of corneal sensitivity due to wearing contact lenses increases the risk of a silent infection.
Trabeculectomy with Long-Term-Stored Mitomycin C in a West Indian Population
Authors: Chen Philip P. , Basich Frank M. , Khadem Erfan
Published: April 2003

We investigated the outcome of trabeculectomy with stored mitomycin C (MMC) in a black Caribbean population on the island of Dominica. Ten eyes (9 patients) underwent trabeculectomy with MMC (0.5 mg/ml for 3–6 min) that had been stored for up to 17 months at 4 °C. The preoperative intraocular pressure of (mean ± SD) 32.8±7.5 mm Hg on 2.6 medications decreased to 9.5±3.2 mm Hg on 0.2 medications after a mean follow-up time of 14.2 months (range 7–25). Nine eyes did not receive medications postoperatively. Complications observed included bleb infection (1 eye) and late bleb leak (1 eye); 2 eyes developed cataract. Nine blebs had typical clinical features of blebs after trabeculectomy with adjunctive MMC. We conclude that long-term-stored MMC may be beneficial as adjunctive treatment in initial trabeculectomy in this population.
Conjunctival Epithelium Expression of HLA-DR in Dry Eye Patients
Authors: Tsubota Kazuo , Fujihara Tsutomu , Saito Keiko , Takeuchi Tsutomu
Published: April 2003

Purpose: To compare conjunctival epithelium expression of HLA-DR and ICAM-1 with tear dynamics and ocular surface parameters. Methods: Brush cytology and flow cytometry were used to quantitatively analyze HLA-DR and ICAM-1 expression in 28 dry eye patients. Results: HLA-DR was expressed in 66% of the conjunctival cells of dry eye patients. This expression correlates with that of ICAM-1, as well as with the Schirmer test results (p < 0.05). Conclusion: This study confirmed that dry eye consists not only of ocular surface desiccation, but also of upregulation of the HLA-DR and ICAM-1 molecule in the conjunctival epithelium, possibly resulting in increased inflammation.
Granular-Lattice (Avellino) Corneal Dystrophy
Authors: Akiya Shinobu , Takahashi Hiroshi , Nakano Nobuhiko , Hirose Naofumi , Tokuda Yasunori
Published: April 2003

Granular-lattice (Avellino) corneal dystrophy has rarely been reported in the literature. It consists of a combination of granular and lattice dystrophy. We describe the histopathologic examination of the corneal button of one Japanese patient who had undergone unilateral keratoplasty because of severely decreased vision caused by what had been diagnosed clinically as granular dystrophy. However, on pathologic examination, lesions characteristic of both granular dystrophy and lattice dystrophy were found. We also describe 2 Japanese patients who had a clinical appearance characteristic of both granular and lattice dystrophy. Granular-lattice corneal dystrophy was found in a wider geographic distribution than previously proposed and should not be named after the geographic area.
Incontinentia pigmenti (Bloch-Sulzberger-Syndrome): Case Report and Differential Diagnosisto Related Dermato-Ocular Syndromes
Authors: Käsmann-Kellner Barbara , Jurin-Bunte Bernadette , Ruprecht Klaus W.
Published: April 2003

Background: Incontinentia pigmenti (IP; Bloch-Sulzberger syndrome) is an inherited disorder of skin pigmentation that is associated with skin (100%), dental (90%), skeletal (40%), central nervous (40%) and ocular (35%) abnormalities. The pathogenesis is not yet known. The disease is usually seen in females, as it is an X-linked dominantly inherited disease which is lethal in males. Patient Presentation: We present a 9-year-old girl with the classical general and ocular signs of IP. She presented in early childhood with inflammatory vesicular skin changes which changed into pigmented skin alterations especially on the trunk. Ocular findings were microphthalmia and retrolental mass formation in one eye and retinal pigmentary changes in the other. In our patient, the spontaneous mutation may have been caused by the family’s close neighbourhood to Semipalatinsk, Kasachstan, where regular nuclear tests took place very shortly before the pregnancy with our patient began. Discussion: Ocular involvement is described in about a third of persons affected with IP. A nearly consistent and pathognomonic finding is a pigment retinopathy (mottled diffuse hypopigmentations). A further consistent finding are abnormalities of peripheral retinal vessels with areas of non-perfusion in the outer retina. The retinal pigment epitheliopathy and the abnormalities of retinal vessels are thought to be the underlying pathognomonic findings, with all other ocular signs being secondary (cataract, leucocoria, optic atrophy, strabismus, nystagmus and microphthalmus). Exudative retinal detachment occurs only in a minority, usually in very early childhood, when the skin lesions are exudative as well. IP patients should, however, be clinically observed regularly because of their retinal pigmentary changes.