bluuebunny/crossref_metadata_2025 huggingface dataset:
Sociodemographic aspects and systemic diseases of cataract patients
Authors: Lumme Pirkko , Laatikainen Leila
Published: May 2009

Abstract. Sociodemographic analysis of 351 consecutive cataract patients operated on at the Oulu University Hospital in 1990 revealed that 30.0% of the patients lived alone at home, 62.1% lived with some other person and 7.9% were in institutions. The mean age was 70.6 ± 12.4 years, the sex distribution (62.7% women, 37.3% men) corresponded with that in the general population of the same age. 78.8% of the patients had had surgery on the first eye, 29.0% of them had low vision or blindness (visual acuity less than 0.3 in the better eye). In the second eye surgery group (21.2% of the patients) low vision or blindness was found in 13.0%. Low vision was more common in institutionalized patients and in those with restricted mobility. In 80.9% of the operated eyes and in 41.5% of the fellow eyes the visual acuity was less than 0.3. 76.6% of the patients had medication for cardiovascular diseases, diabetes, asthma or mental disorders. Based on this survey the demand for cataract surgery is expected to increase in coming years. The majority would be suitable for day case surgery, but for patients living alone, having restricted mobility, poor general health, poor vision in the fellow eye or long distance to the hospital, hospitalization still seems to be a better alternative.
Perforating eye injuries in a western part of Sweden
Authors: Byhr Eva
Published: May 2009

Abstract. We performed a prospective study of all perforating eye injuries in a western part of Sweden during 1989–1991. We registered 140 cases (141 eyes) in a population of 1.4 million. Annual incidence was 3.3 per 100 000 inhabitants. Follow‐up time was 6 months or more in 91 (64%) of the cases. Perforating eye injuries were 5.6 times more common in men than in women. Occupational injuries accounted for 37% of perforating eye injuries. Tweny‐nine per cent of perforating eye injuries were injuries that occurred during domestic and leisure time. In addition to metal fragments, a whole nail was a common perforating object in these groups. Playing activity accounted for 11% of the perforating eye injuries, traffic accidents for 3% and assault for 9%. In a group of elderly patients (9%) perforating eye injuries were caused by falls. Visual acuity was 0.5 or better in 57 (63%) of the eyes with a follow‐up period of at least 6 months. Only 2 of the 141 eyes were enucleated.
Prolonged preoperative prismatic treatment in alternating convergent squint
Authors: Zehetmayer Martin , Stangler‐Zuschrott Elfriede , Schemper Michael
Published: May 2009

Abstract. Our 10‐year retrospective study includes 178 children below the age of 10 years, operated for alternating convergent squint. Inclusion criteria were: Absence of amblyopia and an angle of squint less than 45 pdpt so that alignment of the eyes in only one operation could be expected. One hundred children received preoperatively a prismatic correction of the distance deviation for a period of 6–15 months; 78 cases were treated with glasses and occlusion. In the prism‐treated group a significantly better alignment (p = 0.0001) with a motorial gain of 7–8 pdpt was observed 6 months after surgery; also better sensorial results with significantly (p = 0.0001) more cases of stable NRC or harmonious ARC and improved binocu‐larity were achieved. Unlike the type of esotropia, the preexisting retinal correspondence significantly influenced the motorial outcome (p < 0.05). Fewer reoper‐ations were necessary in the prism‐treated group (p = 0.001). Our results indicate that a prolonged prismatic correction is an effective preoperative treatment in patients with alternating convergent squint.
C‐reactive protein serum levels in patients with ocular disease
Authors: Tervo T. , van Setten G.‐B. , Hovi M. , Pakarinen M. , Tarkkanen A. , Valtonen V.
Published: May 2009

Abstract. Hepatocyte derived C‐reactive protein (CRP) is a sensitive indicator for inflammatory or infectious processes in a variety of tissues. As several other plasma proteins it is regarded as part of the acute phase response to a variety of tissue damage. CRP is commonly used in general medicin as a tool for the follow‐up of especially bacterial infections. However, it has not been widely used in ophthalmology. In the present study CRP values in serum samples from 51 patients with various acute ocular diseases were determined semiquantitatively. High CRP levels were found most frequently in patients with either preseptal cellulitis (83.3%) or endophthalmitis (25.8%) whereas in the serum of patients with keratitis and uveitis, CRP exceeded 20 mg/l in only 18.7% of the cases. In a control group of 10 patients with retinal detachment the mean CRP level was 2.3 mg/l (sd±0.98 mg/ml). The clinical significance and the prognostic value of CRP determinations during ocular diseases are discussed.
Lens opacity in unilateral exfoliation syndrome with or without glaucoma
Authors: Puska Päivi
Published: May 2009

Abstract. The exfoliation syndrome as a risk factor for lens opacification was investigated with pairwise comparisons of lens opacity, visual acuity, refraction, and anterior chamber depth in 126 eyes of 63 patients with unilateral exfoliation syndrome, and in 84 eyes of 42 patients with unilateral capsular glaucoma. As compared with fellow eyes, the exfoliative eyes showed poorer visual acuity (p < 0.05) and more frequent occurrence of subcapsular cataract (2% vs 8%). Compared with the fellow eyes the lenses in the capsular glaucomatous eyes were more opaque, whether without pilocarpine (p < 0.05), or with pilocarpine treatment (p < 0.0001). Visual acuity was poorer (p < 0.01), refraction more myopic (p < 0.05), and anterior chamber depth less (p < 0.05) in the capsular glaucomatous eyes with pilocarpine treatment. Thus, there are slight changes in the lenses of the exfoliative eyes, the cataractous lens changes being more advanced in the capsular glaucomatous eyes.
The persistence of buckle height in relation to orientation of buckle fixation
Authors: Theodossiadis George P. , Maniakis Spyros G. , Ladas Ioannis D. , Theodossiadis Panos G.
Published: May 2009

Abstract. Forty phakic myopic eyes of 40 patients with rhegmatogenous retinal detachment were included in a prospective clinical trial designed to evaluate the changes in buckle height after retinal detachment surgery. The age of the patients ranged between 50 and 75 years. The eyes were divided into two groups (A and B) according to the orientation of sponge fixation. In group A (20 eyes) the sponge fixation was circumferential, while in group B (20 eyes) radial. A‐scan ultrasonography was used for the measurements of buckle height 1, 3, 6, 12, and 18 months postoperatively. At all times of measurement, the buckle height presented a statistically significant difference between the patients of group A and B. More specifically, radial fixation produced a significantly lower scleral indentation compared with that produced by circumferential fixation. After a lapse of 18 months, the buckle height in group B retained 41% of its original value compared with that of group A which retained 66%.
Retinal blood velocities during carbogen breathing using scanning laser ophthalmoscopy
Authors: Arend Oliver , Harris Alon , Martin Bruce J. , Holin Mary , Wolf Sebastian
Published: May 2009

Abstract. Hyperoxic‐hypercapnic gas mixture (‘carbogen’: 6% CO2‐94% O2) is widely used clinically. Its influence on retinal perfusion remains unclear, since past work suggests that high O2 may reduce and high CO2 may increase retinal blood flow. To examine the changes in retinal blood velocity during ‘hyperoxic‐hypercapnic’ gax mixture breathing, we quantified retinal blood velocity indices. Twenty‐eight healthy subjects were studied using scanning laser video fluorescein angiograms at baseline and after gas inhalation. Retinal arteriovenous passage time and mean arterial dye velocity were measured by means of a digital image processing system. Arterial diameter measurements showed no change (4%) during carbogen breathing. Increased arterial Pco2 and Po2 resulted in small but statistically significant increases in systolic and diastolic blood pressure and heart rate (each c. 8%, p < 0.05), and a dramatic increase in mean dye velocity (27%, p < 0.01), with parallel reduction in arteriovenous passage time (40%, p < 0.01). The substantial acceleration of retinal dye velocity and transit under combined hyperoxia and hypercapnia strongly suggests that this clinically standard gas mixture may indeed improve oxygenation without reducing retinal perfusion.
Analysis of tear fluid proteins in insulin‐dependent diabetes mellitus
Authors: Stolwijk Thorsten R. , Kuizenga Ab , Van Haeringen Nico J. , Kijlstra Aize , Oosterhuis Jendo A. , Van Best Jaap A.
Published: May 2009

Abstract. Secretory immunoglobulin A, lactoferrin, lysozyme and tear specific pre‐albumin were analyzed in stimulated tear fluid of 25 diabetic patients without retinopathy and in 29 diabetic patients with (pre‐) proliferative retinopathy using high performance liquid chromatography. Results were compared to those obtained in 26 healthy controls to determine the effect of diabetes mellitus on the exocrine function of the main lacrimal gland. Sodium dodecyl sulfate polyacrylamide gel electrophoresis onto minigels was performed on 20 tear samples for verification of high performance liquid chromatography fractions recorded. The mean total protein values in tear fluid (Bradford assay) of diabetics without retinopathy, with retinopathy and healthy controls did not differ significantly (mean in mg/ml ± sd: 6.4 ± 2.2, 5.9 ± 2.0 and 5.7 ± 1.7, respectively; Mann‐Whitney: p>0.2). High performance liquid chromatography showed an increased secretory immunoglobulin A and decreased peak 5 OD280 (+56% and ‐38%, respectively; p< 0.02) in patients without retinopathy, whereas in patients with retinopathy lysozyme was increased (+27%; p< 0.01) and tear specific pre‐albumin and peak 5 OD280 decreased (‐24% and ‐42%, respectively; p< 0.04), when compared to healthy controls. These inconsistent differences do not uniformly suggest an exocrine dysfunction of the main lacrimal gland in diabetic patients.
Back to front AC IOL implantation combined with penetrating keratoplasty
Authors: Sandboe Frode D. , Medin Walther , Anseth Arvid
Published: May 2009

Abstract. In this retrospective study a simple modification of implanting an intraocular lens into the anterior chamber during penetrating keratoplasty is presented. In 14 patients who underwent penetrating keratoplasty after cataract extraction, the intraocular lens was placed back to front in the anterior chamber so that the haptic was angled anteriorly. Postoperative follow‐up was 18 months on the average. There was significant improvement in vision. All 9 patients with painful bullous keratopathy were relieved of their pain. One case of mild, transient uveitis and glaucoma and two dilated pupils were seen postoperatively. No major complications have been observed so far. This study suggests that this simple method, in some cases, might be favourable when implanting an intraocular lens during penetrating keratoplasty, in the absence of capsular support.
Ocular surface damage and tear lactoferrin in dry eye syndrome
Authors: Danjo Yukitaka , Lee Mitsue , Horimoto Kohji , Hamano Takashi
Published: May 2009

Abstract. We studied the relationship between the severity of ocular surface damage and the level of tear lactoferrin in primary and secondary Sjögren's syndrome and keratoconjunctivitis sicca not associated with Sjögren's syndrome. A significant negative correlation was found between Rose Bengal staining score and level of tear lactoferrin in all three groups. Analysis of covariance disclosed no significant differences in regression lines for Rose Bengal staining score vs tear lactoferrin level among the three groups. The three regression lines appeared to be identical to each other. These findings indicate that the severity of ocular surface damage due to dry eye largely depends on the tear secretory function of the lacrimal gland, and that the function of the lacrimal gland can be evaluated by determination of level of tear lactoferrin using the same standards regardless of differences in pathogenesis of underlying diseases.
Photorefractive keratectomy for low myopia at 5 mm treatment diameter
Authors: Hamberg‐Nyström Helene , Fagerholm Per , Tengroth Björn , Epstein Daniel
Published: May 2009

Abstract. The aim of the study was to evaluate the algorithm and surgical performance of two excimer lasers, the Summit Excimed 200 LA and the VISX 20/20, by assessing visual outcome parameters such as visual acuity and contrast sensitivity, and subjectively estimating dark vision performance. Furthermore, refractive results and centration of the surgically ablated area were assessed. Twenty patients were included in each group. The indications were myopia between ‐2 to ‐5 diopters allowing up to ‐0.75 diopters astigmatism. The treatment diameter was 5 mm. The postoperative treatment was topical dexamethasone for 3 months. The follow‐up time was 12 months. The results showed a median refraction ±0.0D in the Summit group and ‐0.5D in the VISX group 12 months postoperatively. The uncorrected visual acuity was 0.5 (20/40) or better for 100% of the Summit treated eyes, whereas 85% of the VISX treated eyes achieved 0.5 (20/40) or better. The other visual qualities as contrast sensitivity, dark vision and centration of the ablation zone were the same in both groups. The slightly more myopic outcome of the VISX laser explains the poorer average uncorrected visual acuity in this group. We have, as a result of the refractive results, changed our algorithm in the VISX machine to achieve emmetropia. It is our experience that one should try to reach emmetropia in this young population.
Phototherapeutic keratectomy in herpes simplex keratitis
Authors: Fagerholm P. , Öhman L. , Örndahl M.
Published: May 2009

Abstract. Twenty eyes in 20 patients with herpetic keratitis were treated with excimer laser photoablation. Sixteen eyes underwent phototherapeutic keratectomy because of scars and surface irregularities, with the goal to improve vision and 1 eye for cosmetic reasons. Two eyes had slight scars but were treated because of a refractive error (PRK). One eye had a metaherpetic ulcer where the wound surface was ablated with the intention to improve healing. Twelve of the 16 eyes showed improved visual acuity of 2 lines or more on the Snellen chart. The refractive outcome was acceptable in the 2 PRK eyes. The cosmetic result was good and the metaherpetic wound epithelialized within 3 weeks. Of the 20 patients 5 had 1 or more recurrences during the 16.8 months of follow‐up. In the 17 months preceding the laser surgery 9 eyes had 1 or more recurrences. Three of these eyes still showed improved vision. Phototherapeutic excimer laser surgery is advantageous in selected cases and should be considered before corneal grafting. The procedure does not seem to increase the incidence of recurrences.
Transverse keratotomy in postkeratoplasty astigmatism
Authors: Høvding Gunnar
Published: May 2009

Abstract. Transverse relaxing incisions were made in 12 eyes with a mean corneal astigmatism of 10.7D following penetrating keratoplasty. A few days later the mean graft astigmatism had been reduced to 5.5D (p = 0.0022), the reduction being significantly correlated to the degree of astigmatism before the keratotomy was done (p = 0.0044). Thereafter the corneal contour remained fairly stable through a mean follow‐up period of 28.1 months, although a tendency towards a further reduction of the astigmatism was indicated. The mean corrected visual acuity umproved from 0.5 before the keratotomy to 0.7 at the last control visit (p = 0.0117).
Relationship of eye movement to computed tomographic findings in patients with Graves' ophthalmopathy
Authors: Chen Yan‐Ling , Chang Tien‐Chun , Huang Kou‐Mou , Tzeng Shiaw‐Shen , Kao Shine C. S.
Published: May 2009

Abstract. To elucidate the relationship between eye movement and computed tomographic findings, 101 patients with Graves' ophthalmology were studied. Eye movements were scaled 0 to 3 according to movability. Extraocular muscle width and area were calculated from the largest portion of each muscle from the orbital coronal CT sections. Muscle widths were measured manually and muscle areas were calculated by a digitizer. The width and area of each rectus muscle were significantly correlated with limitation of eye movement. The muscle widths and areas were also significantly correlated to each other (r = 0.91 to 0.77, p < 0.001). Limitations of supraduction and abduction from enlargement of the inferior and medial rectus muscles were the most common clinical findings (46.5% and 39.6%, respectively). In conclusion, this study establishes a relationship between limitation of eye movement and extraocular muscle enlargement. Calculation of the width from the largest portion of the muscle manually from orbital coronal section is a simple method for clinical assessment of the severity of extraocular muscle involvement.
Cataract surgery with implantation of IOL in patients with uveitis
Authors: Heger Hilde , Drolsum Liv , Haaskjold Erling
Published: May 2009

Abstract. Traditionally, IOL implantation in eyes with uveitis has not been recommended. In the present study 31 eyes with uveitis which underwent extracapsular cataract extraction or phacoemulsification with IOL implantation, are compared to a reference group consisting of 930 eyes. There was increased postoperative inflammation in 29% in the uveitis group, compared to 5.9% in the reference group. The rate of per‐ and postoperative complications was slightly elevated in the group with uveitis. Corrected visual acuity of 5/8.5 or better was achieved in 58.1%. The major obstacle to good visual acuity postoperatively, was macular pathology.
A study of the axis of orientation of residual astigmatism
Authors: Dunne Mark C. M. , Elawad Mohamed E. A. , Barnes Derek A.
Published: May 2009

Abstract. The aim of this study was to determine the axis of orientation of residual astigmatism in a sample of human eyes applying the principle of astigmatic decomposition. Calculations were carried out on keratoscopic and refractive data collected from the right and left eyes of 70 subjects (37 male and 33 female students) of mixed race (including 25 Asians and 43 Caucasians). No statistically significant difference was found for mean levels of residual astigmatism measured in the right (0.46 DC × 98.2°) and left (0.50 DC × 99.4°) eyes. Residual astigmatism was predominantly against‐the‐rule (83% of right eyes and 66% of left eyes) and was within ± 20° of being perpendicularly disposed relative to the corneal astigmatic power axis in two thirds of the eyes measured. No statistically significant differences were found for either gender or race.
Anterior chamber depth after posterior chamber intraocular lens implantation
Authors: Arai Mikki , Ohzuno Iwao , Zako Masahiro
Published: May 2009

Abstract. The precise behavior of the anterior chamber depth after intraocular lens implantation is uncertain. To ascertain variations in the values at different time points, we measured the anterior chamber depth in 38 eyes that had undergone extracapsular cataract extraction and posterior chamber intraocular lens implantation. Measurements were performed by ultrasonography preoperatively and at 2 days, 1 and 2 weeks postoperatively, and at 1‐month intervals thereafter up to 10 months (mean follow‐up period, 9 months). Results showed that two peaks of the anterior chamber depth occurred at 1 week and 3 months postoperatively (means ± sd, 3.54 ± 0.39 and 3.59 ± 0.43 mm, respectively). A significant difference was found between the values measured preoperatively (3.29 ± 0.57) and at 2 days postoperatively (3.33 ± 0.39) and the 1‐week postoperative value (p < 0.05, using the one‐way analysis of variance test). A significant difference also was found between the preoperative and the monthly measurements and the 3‐month postoperative measurement (p < 0.05). We also calculated the refractive error and found that during the second postoperative week, the refraction tended toward higher myopia that became more hyperopic 3 months postoperatively. This anterior chamber depth variation may cause variations in vision after cataract surgery with intraocular lens implantation.
Transconjunctival sinusotomy using the 193‐nm excimer laser
Authors: Campos Mauro , Lee Paul P. , Trokel Stephen L. , Taylor Hugh R. , McDonnell Peter J.
Published: May 2009

Abstract. Successful surgical management of glaucoma is limited as a consequence of undesired fibroblastic response of episcleral tissues. In 10 rabbit and three human eye bank eyes, we have performed a modified sinusotomy procedure using the 193‐nm excimer laser. The technique is minimally invasive. Conjunctiva is pulled over the corneoscleral limbus, and a slit‐shaped (1times2 mm) excimer beam ablates through conjunctiva and external sclera until penetrating the outer wall of Schlemm's canal, at which time brisk egress of fluid is noted. The conjunctiva is allowed to retract, and a conjunctival bleb is formed. A single suture is used to close the conjunctival defect. Intraocular pressure in the rabbit eye was decreased from 10.0 ± 1.8 to 4.9 ± 1.8 mmHg immediately after surgery (p < 0.0001). Histology revealed a partial thickness, smooth‐walled ablation consistent with a sinusotomy. This procedure is minimally invasive and may be useful for management of glaucoma, particularly when a substantial component of the impediment to aqueous outflow is external to the trabecular meshwork.
Limbal‐conjunctival autograft transplantation in cases with recurrent pterygium
Authors: Güler Murat , Sobaci Güngor , Ilker Sami , Öztürk Faruk , Mutlu F. Mehmet , Yildirim Erol
Published: May 2009

Abstract. This prospective study was undertaken to evaluate limbal conjunctival autotransplantation in the management of cases with recurrent pterygium. At present, new surgical techniques to prevent pterygium recurrence following surgery are in investigation. In recent years, it has been postulated that pterygium is due to hypofunction of limbal stem cells. Thirty‐one out of 49 patients with recurrent pterygium were treated by limbal‐conjunctival autograft transplantation and the other 18 treated by Czermak technique, including two line of limbal cauterization intraoperatively, and used as a control group. During a mean follow‐up period of 10 months (ranging 3–18 months), 4 recurrences (13.3%) in the limbal‐conjunctival autograft transplantation group and 9 recurrences (50%) in the control group were observed. We conclud that this was a successful method to prevent secondary recurrence in the management of recurrent pterygium patients under 40 years of age.
Interocular differences in optic disc configuration in the unilateral exfoliation syndrome
Authors: Tomita Goji , Puska Päivi , Raitta Christina
Published: May 2009

Abstract Thirty‐seven patients with normal visual fields and open angles in both eyes, and lens exfoliation in only one eye, were examined for intraocular pressure, and optic disc topography was determined from stereo‐photographs of the fundi with the computerized three‐dimensional image analyzer. The rim‐to‐disc radius ratios at intervals of 30° were obtained with the instrument. The mean intraocular pressure of the exfoliative eyes (17.5 ± 2.9 mmHg) was significantly higher than that of the nonexfoliative eyes (15.9 ± 2.8 mmHg). In the exfoliative eyes, the mean rim‐to‐disc radius ratio at the inferior‐temporal was significantly smaller, and the higher the intraocular pressure of the exfoliative eye in comparison with that of the nonexfoliative eye, the smaller were the rim‐to‐disc radius ratios at the inferior‐temporal and inferior radii. In the exfoliative eyes, pressure‐dependent changes are observable in the inferior and inferior‐temporal areas of the optic disc prior to visual field loss.
The effect of refractive blur on the detection sensitivity to light offsets in the central visual field
Authors: Mutlukan Erkan
Published: May 2009

Abstract Detection sensitivity to light decrements created on a cathode ray tube was measured along the nasal horizontal meridian of the central visual fields of 5 normal subjects. Decremental (light offset = negative contrast = dark‐on‐bright) static stimuli were presented at 6, 12, 18, 24 and 30° eccentricity. Detection thresholds to rectangular stimuli of both 4 and 16 mm2 (Goldmann equivalent size III and IV, respectively) were determined with ascending staircase single‐crossing technique under various Snellen visual acuity levels. Detection sensitivity diminished with increasing amounts of plus lens‐induced refractive blur. One log unit decrease in visual acuity resulted in elevation of detection thresholds for an average of 3.8 contrast decibels (dB) using size III offset stimuli. The effect of blur was less with size IV offset stimuli which resulted in an average of 0.9 dB elevation in detection thresholds. The larger size decremental stimuli provided a wider dynamic range, less interindividual variation in stimulus visibility and more resistance to refractive error than those obtained with the smaller size stimuli.
Herpes simplex virus type 2 induced retinal necrosis in BALB/c mice
Authors: Zierhut Manfred , Hemady Ramzi , Zhao Tong‐Zhen , Merchant Amyna , Foster C. Stephen
Published: May 2009

Abstract We injected herpes simplex virus type 2 of MS‐ or G‐strain into the anterior chamber of BALB/c mice. In the contralateral eye inflammatory cell infiltration began in the ciliary body; focal retinitis, detected by day 8, led to total destruction of the retina by day 10. Contralateral disease was observed in 75% of mice inoculated with 8 times 103 pfu herpes simplex virus type 2, but in only 20% of mice receiving 80 pfu herpes simplex virus type 2. Still this low concentration, however, produced a suppressed delayed‐type hypersensitivity response. Anti‐herpes simplex virus type 2 antiboy, first detected on day 8, reached hight titers on day 10; by then, most of the mice had died of encephalitis. The G‐strain of herpes simplex virus type 2 was more neurotoxic than the MS‐strain, but produced the same incidence of contralateral retinitis. Herpes simplex virus type 2 produces contralateral necrotizing retinitis comparable to that produced by herpes simplex virus type 1. These findings, like those of other authors, suggest a role for herpes simplex virus type 2 in some cases of acute retinal necrosis in humans.
Massive intracorneal invasion of a ciliary body melanoma
Authors: Seregard Stefan
Published: May 2009

Abstract Massive intracorneal spread from ocular malignant melanoma is an infrequent event. This case illustrates the histopathological features of a large ciliary body melanoma with massive wedge‐like intracorneal invasion, but without extraocular extension.
Opening by the Nd:YAG laser of the anterior portion of the capsular bag in the treatment of delayed onset pseudophakic endophthalmitis
Authors: Neufeld Meir , Loewenstein Anat , Neudorfer Meira , Lazar Moshe
Published: May 2009

Abstract We report on a pseudophakic patient with delayed onset endophthalmitis. The patient was treated twice topically and systemically with antibiotic and steroids with temporary response to treatment. The inflammation recurred twice upon withdrawal of treatment. Upon the third relapse of endophthalmitis the anterior portion of the capsular bag was opened by Nd:YAG laser. A third course of systemic and topical antibiotic and steroid treatment was followed by permanent resolution of inflammation. No relapse occurred during 18 months of follow‐up.
Normal human contrast sensitivity for static and dynamic sinusoidal gratings
Authors: Lundh Björn L.
Published: May 2009

Abstract Contrast thresholds for static and dynamic (phase‐shifted at 2 rps) sinusoidal gratings were established for seven spatial frequencies 0.5–32 c/deg. An HP‐85 desktop computer ran an automated stimulus descending algorithm. Subjects reported stimulus presence by pressing a switch. Two stimulus presentation designs were used. In method 1, the screen was blanked to mean luminance between presentations, while in method 2 the pattern remained unchanged until the next contrast level was presented. Mean thresholds were calculated from three successive threshold passages using 2 dB steps. Fifty‐nine volunteers from a military unit, mean age 20 years, participated in the study. Method 1 always gave lower thresholds with less variability. For static gratings, this was statistically significant at 0.5 and 16 c/deg (p<0.01 and 0.05, respectively) and for dynamic gratings at all spatial frequencies except 32 c/deg (p<0.1 for 0.5 and 16 c/deg, p < 0.001 for 1–8 c/deg). An accuracy index was calculated from two determinations at 4 c/deg. Method 1 gave higher indices for both static and dynamic patterns, although not statistically significant. However, method 1 was significantly more time consuming. Method 1 was considered the more reliable of the two contrast threshold determining designs.
Interferon alpha‐2a in the treatment of exudative senile macular degeneration
Authors: Jaakkola Aino , Anttila Pekka M. , Immonen Ilkka
Published: May 2009

Abstract We performed a pilot study of 10 patients with the objective to determine the efficacy of interferon alpha‐2a in the treatment of age‐related macular degeneration with freshly diagnosed choroidal neovascular membrane. Interferon was given at a dose of 3 MIU/m2 three times a week for 8 weeks. Mean age of the patients was 74 years. In 3 patients we combined laser photocoagulation of extrafoveal part of the choroidal neovascular membrane to interferon therapy. The patients were followed up for 1 year after termination of interferon treatment. In 1 patient a visual improvement of two Snellen lines was noted, while in 7 patients visual acuity remained the same during the treatment (includes 3 patients treated with combined Krypton‐laser photocoagulation). In 2 patients there was a decrease in acuity of one line. Six months later visual acuity had deteriorated in 7 patients and 1 year later all the patients had visual acuity ≤ 20/200. We did not find any regression of choroidal neovascular membrane in fluorescein angiography in any of the patients during the treatment except the laser‐treated area. At the 6‐month follow‐up there was still leakage or choroidal neovascular membrane growth in 6 patients. Combined interferon‐laser therapy did not prove to be more effective in preventing the membrane growth. Side‐effects included weakness, apathy, and fatigue in this elderly population. Our results indicate that treatment with 3 MIU/m2 interferon for 8 weeks is not an effective treatment for subfoveal choroidal neovascular membranes.
Early changes in diabetic retinopathy: Capillary loss and blood‐retina barrier permeability in relation to metabolic control
Authors: Sander Birgit , Larsen Michael , Engler Claus , Lund‐Andersen Henrik , Parving Hans‐Henrik
Published: May 2009

Abstract In diabetic retinopathy capillary loss and blood‐retina barrier leakage are prominent factors. We present a study with quantitative measurements of both capillary loss and leakage and their relation to cumulative metabolic control. Seventeen insulin‐dependent diabetic patients with no retinopathy or only mild background retinopathy and 10 years' duration of the disease were included in the study. Status of metabolic regulation had been followed for at least 6 years. Seven healthy subjects were included as controls. In diabetic patients the perifoveal intervascular areas were found to increase significantly with the cumulative HbAlc index (p = 0.02) and in relation to the presence of moderate background retinopathy (p < 0.02). The blood‐retina barrier leakage and the area of the foveal avascular zone were not significantly different from healthy subjects and no correlation was found between the HbAlc index and blood‐retina barrier permeability. We conclude that perifoveal capillary loss occurs early in the course of diabetic retinopathy and that this loss is related to prior glycemic control and to the ophthalmoscopic retinopathy level.
Preoperative ocular disinfection by the use of povidone‐iodine 5%
Authors: Dereklis Dimitrios L. , Bufidis Theodoras A. , Tsiakiri Eleni P. , Palassopoulos Spiros I.
Published: May 2009

Abstract Numerous disinfective methods have been proposed in order to prevent intraocular infections during eye operations. In a clinical‐laboratory study we evaluated the effectiveness of povidone‐iodine solution 5% as a preventive ‐ preoperative means of conjunctival antisepsis prior to ocular surgery. Conjunctival cultures were performed on 100 patients. Group A (50 patients) had their fornices washed with normal saline immediately before surgery. In Group B (50 patients) one drop of povidone‐iodine solution 5% was applied prior to preoperative wash of the fornices with normal saline. Thirty‐three out of 50 eyes from Group A had positive cultures (66%). Only 15 out of 50 eyes from Group B had positive cultures (30%). Bacteria flora differed in the two groups, with Group A exhibiting more dangerous strains. Pre‐operative‐preventive disinfection with povidone‐iodine 5% may prove to be advantageous to ocular surgery.
Local specific immunotherapy in allergic conjunctivitis
Authors: Del Prete A. , Loffredo C. , Carderopoli A. , Caparello O. , Verde R. , Sebastiani A.
Published: May 2009

Abstract We evaluated the effect of local specific immunotherapy in 40 patients suffering from seasonal allergic conjunctivitis. Twenty patients received saline solution in both eyes; and 20 others received local specific immunotherapy in both eyes. Sodium cromoglycate drops were instilled in both eyes in all patients. Subjective and objective symptoms, and cytological findings had significantly improved after 1 year in the group treated with local specific immunotherapy plus sodium cromoglycate compared to the group treated with sodium cromoglycate and saline solution.
The Zoonotic Flaviviruses of Southern, South‐Eastern and Eastern Asia, and Australasia: The Potential for Emergent Viruses
Authors: Mackenzie J. S. , Williams D. T.
Published: May 2009

The genus Flaviviridae comprises about 70 members, of which about 30 are found in southern, south‐eastern and eastern Asia and Australasia. These include major pathogens such as Japanese encephalitis (JE), West Nile (WN), Murray Valley encephalitis (MVE), tick‐borne encephalitis, Kyasanur Forest disease virus, and the dengue viruses. Other members are known to be associated with mild febrile disease in humans, or with no known disease. In addition, novel flaviviruses continue to be discovered, as demonstrated recently by New Mapoon virus in Australia, Sitiawan virus in Malaysia, and ThCAr virus in Thailand. About 19 of these viruses are mosquito‐borne, six are tick‐borne, and four have no known vector and represent isolates from rodents or bats. Evidence from phylogenetic studies suggest that JE, MVE and Alfuy viruses probably emerged in the Malaya‐Indonesian region from an African progenitor virus, possibly a virus related to Usutu virus. WN virus, however, is believed to have emerged in Africa, and then dispersed through avian migration. Evidence suggests that there are at least seven genetic lineages of WN virus, of which lineage 1b spread to Australasia as Kunjin virus, lineages 1a and 5 spread to India, and lineage 6 spread to Malaysia. Indeed, flaviviruses have a propensity to spread and emerge in new geographic areas, and they represent a potential source for new disease emergence. Many of the factors associated with disease emergence are present in the region, such as changes in land use and deforestation, increasing population movement, urbanization, and increasing trade. Furthermore, because of their ecology and dependence on climate, there is a strong likelihood that global warming may significantly increase the potential for disease emergence and/or spread.
Emerging Infections: A Tribute to the One Medicine, One Health Concept
Authors: Kahn R. E. , Clouser D. F. , Richt J. A.
Published: May 2009

Events in the last decade have taught us that we are now, more than ever, vulnerable to fatal zoonotic diseases such as those caused by haemorrhagic fever viruses, influenza, rabies and BSE/vCJD. Future research activities should focus on solutions to these problems arising at the interface between animals and humans. A 4‐fold classification of emerging zoonoses was proposed: Type 1: from wild animals to humans (Hanta); Type 1 plus: from wild animals to humans with further human‐to‐human transmission (AIDS); Type 2: from wild animals to domestic animals to humans (Avian flu) and Type 2 plus: from wild animals to domestic animals to humans, with further human‐to‐human transmission (Severe Acute Respiratory Syndrome, SARS). The resulting holistic approach to emerging infections links microbiology, veterinary medicine, human medicine, ecology, public health and epidemiology. As emerging ‘new’ respiratory viruses are identified in many wild and domestic animals, issues of interspecies transmission have become of increasing concern. The development of safe and effective human and veterinary vaccines is a priority. For example, the spread of different influenza viruses has stimulated influenza vaccine development, just as the spread of Ebola and Marburg viruses has led to new approaches to filovirus vaccines. Interdisciplinary collaboration has become essential because of the convergence of human disease, animal disease and a common approach to biosecurity. High containment pathogens pose a significant threat to public health systems, as well as a major research challenge, because of limited experience in case management, lack of appropriate resources in affected areas and a limited number of animal research facilities in developed countries. Animal models that mimic certain diseases are key elements for understanding the underlying mechanisms of disease pathogenesis, as well as for the development and efficacy testing of therapeutics and vaccines. An updated veterinary curriculum is essential to empower future graduates to work in an international environment, applying international standards for disease surveillance, veterinary public health, food safety and animal welfare.
Nitric oxide‐induced biphasic mechanism of vascular relaxation via dephosphorylation of CPI‐17 and MYPT1
Authors: Kitazawa Toshio , Semba Shingo , Huh Yang Hoon , Kitazawa Kazuyo , Eto Masumi
Published: May 2009

Nitric oxide (NO) from endothelium is a major mediator of vasodilatation through cGMP/PKG signals that lead to a decrease in Ca2+concentration. In addition, NO‐mediated signals trigger an increase in myosin light chain phosphatase (MLCP) activity. To evaluate the mechanism of NO‐induced relaxation through MLCP deinhibition, we compared time‐dependent changes in Ca2+, myosin light chain (MLC) phosphorylation and contraction to changes in phosphorylation levels of CPI‐17 at Thr38, RhoA at Ser188, and MYPT1 at Ser695, Thr696 and Thr853 in response to sodium nitroprusside (SNP)‐induced relaxation in denuded rabbit femoral artery. During phenylephrine (PE)‐induced contraction, SNP reduced CPI‐17 phosphorylation to a minimal value within 15 s, in parallel with decreases in Ca2+and MLC phosphorylation, followed by a reduction of contractile force having a latency period of about 15 s. MYPT1 phosphorylation at Ser695, the PKG‐target site, increased concurrently with relaxation. Phosphorylation of RhoA, MYPT1 Thr696 and Thr853 differed significantly at 5 min but not within 1 min of SNP exposure. Inhibition of Ca2+release delayed SNP‐induced relaxation while inhibition of Ca2+channel, BKCachannel or phosphodiesterase‐5 did not. Pretreatment of resting artery with SNP suppressed an increase in Ca2+, contractile force and phosphorylation of MLC, CPI‐17, MYPT1 Thr696 and Thr853 at 10 s after PE stimulation, but had no effect on phorbol ester‐induced CPI‐17 phosphorylation. Together, these results suggest that NO production suppresses Ca2+release, which causes an inactivation of PKC and rapid CPI‐17 dephosphorylation as well as MLCK inactivation, resulting in rapid MLC dephosphorylation and relaxation.
Sympathetic responses during saline infusion into the veins of an occluded limb
Authors: Cui Jian , McQuillan Patrick , Moradkhan Raman , Pagana Charles , Sinoway Lawrence I.
Published: May 2009

Animal studies have shown that the increased intravenous pressure stimulates the group III and IV muscle afferent fibres, and in turn induce cardiovascular responses. However, this pathway of autonomic regulation has not been examined in humans. The aim of this study was to examine the hypothesis that infusion of saline into the venous circulation of an arterially occluded vascular bed evokes sympathetic activation in healthy individuals. Blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) responses were assessed in 19 young healthy subjects during local infusion of 40 ml saline into a forearm vein in the circulatory arrested condition. From baseline (11.8 ± 1.2 bursts min−1), MSNA increased significantly during the saline infusion (22.5 ± 2.6 bursts min−1, P < 0.001). Blood pressure also increased significantly during the saline infusion. Three control trials were performed during separate visits. The results from the control trial show that the observed MSNA and blood pressure responses were not due to muscle ischaemia. The present data show that saline infusion into the venous circulation of an arterially occluded vascular bed induces sympathetic activation and an increase in blood pressure. We speculate that the infusion under such conditions stimulates the afferent endings near the vessels, and evokes the sympathetic activation.
Distinct effects of subcellular glycogen localization on tetanic relaxation time and endurance in mechanically skinned rat skeletal muscle fibres
Authors: Nielsen J. , Schrøder H. D. , Rix C. G. , Ørtenblad N.
Published: May 2009

In vitro experiments indicate a non‐metabolic role of muscle glycogen in contracting skeletal muscles. Since the sequence of events in excitation–contraction (E–C) coupling is known to be located close to glycogen granules, at specific sites on the fibre, we hypothesized that the distinct compartments of glycogen have specific effects on muscle fibre contractility and fatigability. Single skeletal muscle fibres (n= 19) from fed and fasted rats were mechanically skinned and divided into two segments. In one segment glycogen localization and volume fraction were estimated by transmission electron microscopy. The other segment was mechanically skinned and, in the presence of high and constant myoplasmic ATP and PCr, electrically stimulated (10 Hz, 0.8 s every 3 s) eliciting repeated tetanic contractions until the force response was decreased by 50% (mean ±s.e.m., 81 ± 16, range 22–252 contractions). Initially the total myofibrillar glycogen volume percentage was 0.46 ± 0.07%, with 72 ± 3% in the intermyofibrillar space and 28 ± 3% in the intramyofibrillar space. The intramyofibrillar glycogen content was positively correlated with the fatigue resistance capacity (r2= 0.32, P= 0.02). Intermyofibrillar glycogen was inversely correlated with the half‐relaxation time in the unfatigued tetanus (r2= 0.25, P= 0.03). These results demonstrate for the first time that two distinct subcellular populations of glycogen have different roles in contracting single muscle fibres under conditions of high myoplasmic ATP.
Sequence Analyses of Just Four Genes To Detect Extensively Drug-Resistant
Mycobacterium tuberculosis
Strains in Multidrug-Resistant Tuberculosis Patients Undergoing Treatment
Authors: Feuerriegel Silke , Cox Helen S. , Zarkua Nana , Karimovich Hamraev A. , Braker Kai , Rüsch-Gerdes Sabine , Niemann Stefan
Published: May 2009

The rapid detection of
Mycobacterium tuberculosis
isolates resistant to second-line drugs is crucial for the institution of appropriate treatment regimens as early as possible. Although molecular methods have successfully been used for the rapid detection of resistance to first-line drugs, there are limited data on mutations that confer resistance to second-line drugs. To address this question, we analyzed
Mycobacterium tuberculosis
strains resistant to ofloxacin (
n
= 26) and to capreomycin and/or amikacin (
n
= 48) from Uzbekistan for variations in target genes (
gyrA
,
gyrB
,
rrs
, and
tlyA
). Strains susceptible to ofloxacin (
n
= 49) and capreomycin and/or amikacin (
n
= 39) were included as controls. Mutations in
gyrA
or
gyrB
were found in 96% (25/26 strains) of the ofloxacin-resistant strains, while none of the susceptible strains displayed mutations in those two genes. The most common mutation occurred in
gyrA
at codon 94 (17/26 strains [65.4%]), followed by mutations at codons 90 and 91. Two strains showed a mutation in
gyrB
, at codons 485 and 543, respectively; both mutations have not been reported previously. The most frequent mutation in strains resistant to both amikacin and capreomycin was A1401G in
rrs
(34/40 strains [85.0%]). Three strains had mutations in
tlyA
, of which two (at codons 18 and 118) were associated with resistance to capreomycin alone. Overall, none of the 10 resistant strains (5 amikacin-resistant and capreomycin-susceptible strains) and none of the 39 susceptible control strains had mutations in the genes investigated. Our results clearly demonstrate the potential of sequence analyses of short regions of relatively few target genes for the rapid detection of resistance to second-line drugs among strains isolated from patients undergoing treatment for multidrug-resistant tuberculosis. The mechanisms that confer amikacin resistance in this setting remain unclear.
Outer Membrane Protein STM3031 (Ail/OmpX-Like Protein) Plays a Key Role in the Ceftriaxone Resistance of
Salmonella enterica
Serovar Typhimurium
Authors: Hu Wensi S. , Lin Jing-Fang , Lin Ying-Hsiu , Chang Hsin-Yu
Published: May 2009

Previously, the putative outer membrane protein STM3031 has been correlated with ceftriaxone resistance in
Salmonella enterica
serovar Typhimurium. In this study, this protein was almost undetectable in the ceftriaxone-susceptible strain 01-4, but its levels were increased in 01-4 isogenic strains for which MICs were higher. The
stm3031
gene deletion mutant, R200(Δ
stm3031
), was generated and showed >64-fold lower ceftriaxone resistance than R200, supporting a key role for STM3031 in ceftriaxone resistance. To investigate which outer membrane protein(s) was associated with resistance, the outer membrane protein profiles of 01-4, R200, and R200(Δ
stm3031
) were compared proteomically. Nine proteins were identified as altered. The expression levels of AcrA, TolC, STM3031, STM1530, VacJ, and Psd in R200 were increased; those of OmpC, OmpD, and OmpW were decreased. The expression levels of OmpD, OmpW, STM1530, VacJ, and Psd, but not those of OmpC, AcrA, and TolC, in R200(Δ
stm3031
) were returned to the levels in strain 01-4. Furthermore, the genes' mRNA levels correlated with their protein levels when the three strains were compared. The detection of higher AcrB levels, linked to higher
acrB
,
acrD
, and
acrF
mRNA levels, in strain R200 than in strains 01-4 and R200(Δ
stm3031
) suggests that AcrB, AcrD, and AcrF participate in ceftriaxone resistance. Taken together with the location of STM3031 in the outer membrane, these results suggest that STM3031 plays a key role in ceftriaxone resistance, probably by reducing permeability via a decreased porin OmpD level and enhancing export via increased AcrD efflux pump activity.