bluuebunny/crossref_metadata_2025 huggingface dataset:
Vardenafil is effective and well‐tolerated for treating erectile dysfunction in a broad population of men, irrespective of age
Authors: Giuliano François , Donatucci Craig , Montorsi Francesco , Auerbach Stephen , Karlin Gary , Norenberg Christiane , Homering Martin , Segerson Thomas , Eardley Ian ,   Vardenafil Study Group
Published: December 2004

OBJECTIVES

To assess the efficacy and safety of vardenafil in the treatment of erectile dysfunction (ED) in men of different age groups.

PATIENTS AND METHODS

In a retrospective pooled subgroup analysis of randomized, double‐blind, placebo‐controlled studies, men from the general population with ED received either placebo or vardenafil 5, 10 or 20 mg over 12 weeks. Efficacy variables included the erectile function (EF) domain score from The International Index of Erectile Function, diary response rates to questions on vaginal penetration and maintenance of erection, and positive responses to the Global Assessment Question (GAQ) ‘Has the treatment you have been taking over the past 4 weeks improved your erections?’. The 1385 men were grouped by age (<45, 45–64 and ≥65 years).

RESULTS

At 12 weeks the EF domain scores approached 20 with vardenafil and 14 with placebo in men aged ≥ 65 years (P < 0.03 vardenafil 5 mg vs placebo, P < 0.001 vardenafil 10 and 20 mg vs placebo). The corresponding scores were 22 and 14 in men aged 45–64 years and up to 24 and 16 in those aged <45 years (P < 0.03 vardenafil 5 mg vs placebo, P < 0.001 vardenafil 10 and 20 mg vs placebo). Vardenafil generated positive GAQ responses in ≈ 71%, 76% and 85% of men aged <45, 45–64 and ≥ 65 years (P ≤ 0.001 vardenafil vs placebo). The corresponding placebo rates were 23%, 25% and 34%. The most common treatment‐emergent adverse events were headache, rhinitis, flushing and dyspepsia, which were mild to moderate, transient and unrelated to age.

CONCLUSION

Vardenafil is an effective and generally well‐tolerated treatment for ED, irrespective of age.
Comparison of laparoscopic and open donor nephrectomy: UK experience
Authors: Wilson Colin H. , Bhatti Aftab A. , Rix David A. , Soomro Naeem A.
Published: December 2004

A comparison of laparoscopic and open donor nephrectomy is presented by authors from the UK. They found that the laparoscopic approach could safely be offered to patients treated in experienced units and after adequate training fo the surgeon, with no increase in complications or decrease in efficacy.

OBJECTIVE

To compare our early experience of laparoscopic donor nephrectomy (LDN) with a contemporary cohort of conventional open donor nephrectomy (ODN).

PATIENTS AND METHODS

Transperitoneal left‐sided LDN was offered to carefully selected potential live kidney donors on the basis of vascular anatomy. The first 20 donors who underwent LDN were compared with a control group of 20 patients who had ODN. Donors and recipients were compared for demographics, intraoperative variables, postoperative complications and allograft function.

RESULTS

There was no peri‐operative mortality in either group. No laparoscopic procedure required open conversion. The operating time was comparable (165 vs 153 min); LDN was associated with significantly less intraoperative blood loss (200 vs 350 mL; Mann‐Whitney U, P = 0.01) and hospital stay (3 vs 5 days; P < 0.001). The graft warm ischaemic time was significantly longer for LDN (5 vs 2 min; P < 0.001) but this did not appear to affect either the delayed graft function rate (5% vs 10%, not significant) or serum creatinine level at discharge (125 vs 126 µmol/L).

CONCLUSIONS

UK centres with experience of advanced laparoscopy and ODN can safely offer LDN to potential live donors.
Systemic stress responses in patients undergoing surgery for benign prostatic hyperplasia
Authors: Ruzic Boris , Tomaskovic Igor , Trnski Davor , Kraus Ognjen , Bekavac‐Beslin Miroslav , Vrkic Nada
Published: December 2004

OBJECTIVE

To determine differences in systemic stress responses in patients undergoing three different types of surgery for benign prostatic hyperplasia (BPH), evaluated by measuring levels of stress variables, i.e. cortisol; acute‐phase reactants, i.e. C‐reactive protein (CRP) and fibrinogen; and antioxidants, i.e. total antioxidant status (TAS) and superoxide dismutase (SOD).

PATIENTS AND METHODS

The study included 80 patients who fulfilled the inclusion criteria for surgery for BPH. Based on an ultrasonographic estimate of the prostate volume before surgery, all patients were allocated to one of three groups; group 1, prostate ≤ 30 g and treated with transurethral incision of the prostate (TUIP); group 2, prostate 30–80 g, treated with transurethral resection of the prostate (TURP); and group 3, prostate >80 g, treated with a suprapubic transvesical prostatectomy (TP). Blood samples were taken from each patient on the day before and the day after surgery, and the acute‐phase reactants and antioxidants measured; cortisol concentrations were also measured in 24‐h urine samples the day before and 3 days after surgery.

RESULTS

There were significantly higher levels of cortisol, CRP and TAS, and significantly lower levels of fibrinogen and SOD in all study groups after surgery than before. Surgery and associated conditions, e.g. excitement, fear, blood loss, etc., lead to traumatic and oxidative stress, followed by a strong systemic stress response during and after surgery. Low fibrinogen levels after surgery had a different pattern from the other acute‐phase reactants, as a result of increased fibrinolytic activity after TURP and TP.

CONCLUSION

The extent of the systemic stress response correlated fairly well with the degree of tissue damage, which differed in the three groups. Suprapubic TP caused the most tissue trauma and triggered the strongest systemic stress response. This response was moderate after TURP, while TUIP (a minor intervention) caused the least stress. Specific changes in stress markers could be used to improve surgery for BPH. Whether there is a benefit of antioxidant therapy during surgery for BPH should be evaluated in further studies.
Prostate cancer: socio‐economic, geographical and private‐health insurance effects on care and survival
Authors: Hall Sonĵa E. , Holman C. D’Arcy J. , Wisniewski Z. Stan , Semmens James
Published: December 2004

OBJECTIVE

To examine the effects of demographic, geographical and socio‐economic factors, and the influence of private health insurance, on patterns of prostate cancer care and 3‐year survival in Western Australia (WA).

PATIENTS AND METHODS

The WA Record Linkage Project was used to extract all hospital morbidity, cancer and death records of men diagnosed with prostate cancer between 1982 and 2001. The likelihood of having a radical prostatectomy (RP) was estimated using logistic regression, and the likelihood of death 3 years after diagnosis was estimated using Cox regression.

RESULTS

The proportion of men undergoing RP increased six‐fold, from 3.1% to 20.1%, over the 20 years, whilst non‐radical surgery (transurethral, open or closed prostatectomy) simultaneously halved to 29%. Men who had RP were typically younger, married and with less comorbidity. Patients with a first admission to a rural hospital were much less likely to have RP (odds ratio 0.15; 95% confidence interval, CI, 0.11–0.21), whereas residence alone in a rural area had less effect (0.54, 0.29–1.03). A first admission to a private hospital increased the likelihood of having RP (2.40, 2.11–2.72), as did having private health insurance (1.77, 1.56–2.00); being more socio‐economically disadvantaged reduced RP (0.63, 0.47–0.83). The 3‐year mortality rate was greater with a first admission to a rural hospital (relative risk 1.22; 95% CI 1.09–1.36) and in more socio‐economically disadvantaged groups (1.34, 1.10–1.64), whereas those admitted to a private hospital (0.77, 0.71–0.84) or with private health insurance (0.82, 0.76–0.89) fared better. Men who had RP had better survival than those who had non‐radical surgery (4.85, 3.52–6.68) or no surgery (6.42, 4.65–8.84), although this may be an artefact of a screening effect.

CONCLUSION

The 3‐year survival was poorer and the use of RP less frequent in men from socio‐economically and geographically disadvantaged backgrounds, particularly those admitted to rural or public hospitals, and those with no private health insurance.
Inhibitory actions of calcitonin gene‐related peptide and capsaicin: evidence for local axonal reflexes in the bladder wall
Authors: Gillespie James I.
Published: December 2004

OBJECTIVES

To explore the actions of capsaicin and the neurotransmitters released by capsaicin (substance P and calcitonin gene‐related peptide, CGRP) on the phasic contractile activity generated in the whole isolated guinea pig bladder by muscarinic stimulation, and to examine the hypothesis that collateral fibres of sensory axons contribute to a local reflex in the bladder wall.

MATERIALS AND METHODS

All experiments used whole isolated bladders from female guinea pigs (270–300 g). Bladders were cannulated via the urethra to measure intravesical pressure and suspended in a heated chamber containing oxygenated Tyrode's solution at 33–35 °C. All drugs were added to the solution bathing the abluminal surface.

RESULTS

Application of capsaicin (10 µmol/L) to the whole isolated bladder resulted in complex changes in the frequency and amplitude of phasic activity generated by muscarinic stimulation; an initial burst of activity involving a rise in frequency, a second phase of reduced amplitude and frequency and a third phase where the amplitude of the transients recovered and the frequency increased. Capsaicin had no effect on the phasic activity generated by the nicotinic ligand lobeline (30 µmol/L). As capsaicin releases the neurotransmitter content of the sensory nerves, experiments explored the actions of CGRP and substance P on the muscarinic‐induced activity. CGRP (3–30 nmol/L) reduced the amplitude and slowed the frequency of the phasic activity. On washing off CGRP the amplitude and frequency of the transient activity recovered and there was a transient increase in frequency above the levels before stimulation. There was also evidence of a desensitization to CGRP on repeated application. In contrast, substance P (100–300 nmol/L) increased the frequency of the transients, while on removing it there was an inhibition of both amplitude and frequency.

CONCLUSIONS

These results suggest that neurotransmitters released from sensory nerve endings in the guinea pig bladder wall affect phasic activity. The direct application of CGRP inhibited phasic activity while substance P was excitatory, indicating the specific contributions of these neurotransmitters. The excitation after stimulation with CGRP and inhibition with substance P may indicate that these neurotransmitters feed back on the sensory nerves to induce transmitter release. Taken together, these observations suggest the presence of a local reflex in the bladder wall, where axon collaterals of afferent sensory fibres innervate the pacemaker mechanism in the bladder wall responsible for generating phasic activity. The possible importance of this reflex in the physiology and pathophysiology of the bladder is discussed.
SIMD Optimization of Linear Expressions for Programmable Graphics Hardware
Authors: Bajaj Chandrajit , Ihm Insung , Min Jungki , Oh Jinsang
Published: December 2004

The increased programmability of graphics hardware allows efficient graphical processing unit (GPU) implementations of a wide range of general computations on commodity PCs. An important factor in such implementations is how to fully exploit the SIMD computing capacities offered by modern graphics processors. Linear expressions in the form of
, where A is a matrix, and and are vectors, constitute one of the most basic operations in many scientific computations. In this paper, we propose a SIMD code optimization technique that enables efficient shader codes to be generated for evaluating linear expressions. It is shown that performance can be improved considerably by efficiently packing arithmetic operations into four‐wide SIMD instructions through reordering of the operations in linear expressions. We demonstrate that the presented technique can be used effectively for programming both vertex and pixel shaders for a variety of mathematical applications, including integrating differential equations and solving a sparse linear system of equations using iterative methods.
Placement of Deformable Objects
Authors: Schein S. , Elber G.
Published: December 2004

With the increasing complexity of photorealistic scenes, the question of building and placing objects in three‐dimensional scenes is becoming ever more difficult. While the question of placement of rigid objects has captured the attention of researchers in the past, this work presents an intuitive and interactive scheme to properly place deformable objects with the aid of free‐form deformation tools. The presented scheme can also be used to animate the locomotion of nonrigid objects, most noticeably animals, and adapt the motion to arbitrary terrain. The automatic construction of our free‐form deformation tool is completely hidden from the end user, and hence, circumvents the difficulties typically faced in manipulating these deformation functions. Further, a precise bound on the error that is introduced by applying free‐form deformations to polygonal models is presented, along with an almost‐optimal adaptive refinement algorithm to achieve a certain accuracy in the mapping.
Physical Validation of Global Illumination Methods: Measurement and Error Analysis
Authors: Schregle Roland , Wienold Jan
Published: December 2004

In this paper, we present a physical validation of global illumination algorithms based on measurements from a simple experimental setup. The validation methodology emphasizes tractability and error minimization. To this end, we discuss issues such as the acquisition and accurate simulation of material bidirectional reflection distribution functions (BRDFs) and the light source distribution, as well as error analysis. In addition, we present a nearest‐neighbor resampling technique for BRDFs and a simple method for extracting the light source distribution from digitized high dynamic range (HDR) images. Finally, we compare the measurements to a forward and backward raytracing solution (photon map and RADIANCE, respectively) in a set of case studies.
Cytokine and Prostaglandin E2 Release from Leukocytes in Response to Metal Ions Derived from Different Prosthetic Materials: An In Vitro Study
Authors: Liu Hwa‐Chang , Chang Walter Hong‐Shong , Lin Feng‐Huei , Lu Kuan‐How , Tsuang Yang‐Hwei , Sun Jui‐Sheng
Published: December 2004

Abstract: Cytokines produced by leukocytes in the periprosthetic membranes surrounding joint replacements have been implicated as causal agents in osteolysis and prosthetic loosening. In this study, we used an in vitro leukocyte culture system to monitor the response of leukocytes to various metal ions and their possible roles in the mechanism of aseptic loosening. Human peripheral leukocytes were isolated and incubated with various concentrations of Co2+, Cr3+, and Ti3+ ions. Leukocyte cell counts and the levels of the tumor necrosis factor‐α (TNF‐α), interleukin‐1 (IL‐1), interleukin‐6 (IL‐6) and prostaglandin E2 (PGE2) released into the media were analyzed at 1 h, 3 h, and 1, 3, and 7 day intervals. The results showed that adding different metal ions into leukocyte cultures did not affect the cell counts. Exposure of leukocytes to Co2+ ion increased the release of TNF‐α, IL‐6, and PGE2. Exposure of leukocytes to Cr3+ ion did not increase the release of TNF‐α but increased the secretion of IL‐6 and PGE2. In contrast, exposure of the leukocytes to Ti3+ ions was associated with a decrease in the release of TNF‐α and PGE2 and a minimal change in IL‐6 noted after 7 days' culture. The present study elucidated the possible mechanisms involved in periprosthetic osteolysis and the inflammatory response of human leukocytes to metal ions. We found that cobalt ion is the most potent stimulant for cytokines and prostaglandin secretion by leukocytes. This elucidation, in combination with other efforts to reduce the generation of wear debris and metal ions, may improve the longevity of orthopedic implants.
Open‐loop Analysis of Transfer Characteristics from Blood Pressure to Heart Rate Using an Effectively Total Artificial Heart
Authors: Tanaka Akira , Yoshizawa Makoto , Abe Ken‐ichi , Takeda Hiroshi , Yambe Tomoyuki , Nitta Shin‐ichi , Abe Yusuke , Chinzei Tsuneo , Imachi Kou
Published: December 2004

Abstract:   It is desirable for the dynamic behavior of the drive rate of the artificial heart to be as similar as possible to that of the recipient's heart rate (HR) before implantation. This requires a model which can simulate the behavior of HR on the basis of only the information measured with the limited number of approvable implanted sensors. This article provides a linear time series model for explaining the behavior of HR only with aortic pressure and right atrial pressure. This could be obtained from open‐loop analysis using a total artificial heart, which was introduced for measuring HR in vivo and for eliminating its effect on blood pressure.

The model was identified in a goat equipped with a special biventricular assist device called the effectively total artificial heart (ETAH). The ETAH was introduced to make an open loop and awake situation in the animal with almost intact autonomic nerves, which could enhance the accuracy and reliability of the identification of the model. The adequacy of the proposed model was ascertained in several data sets measured in two goats, which were different from the data set used for identification. Most of the mean estimation errors were less than 3 beats/min and auto‐correlation analysis showed approvable statistical appropriateness. However, it was clarified through comparison with the 1/R control method that the proposed model has a few problems still to be solved before its future implementation as an automatic controller of the TAH.
The Action of Low‐intensity Pulsed Ultrasound in Bones of Osteopenic Rats
Authors: Carvalho Daniela C.L. , Cliquet Alberto
Published: December 2004

Abstract:   In this study, the action of low‐intensity pulsed ultrasound for 20 min/day, during twenty days, was analyzed in an attempt to revert bone loss in the proximal femur of osteopenic rats.

Although the quantitative results of bone mineral content (BMC) demonstrated no significant difference among the groups (P > 0.05), the histologic investigations have shown the occurrence of recent bone formation not observed in the nontreated group. Moreover, the treated femur presented less microarchitectural deterioration than the nontreated group. These results suggest that the low‐intensity ultrasound can interfere in a positive way on osteoporosis.
Oxygen Consumption in a Hollow Fiber Bioartificial Liver—Revisited
Authors: Patzer John F.
Published: December 2004

Abstract:  Oxygen consumption dynamics in a hollow fiber, hepatocyte‐loaded bioartificial liver are investigated both theoretically and experimentally. The theoretical model is based upon the Krogh cylinder, which approximates the bioreactor as a collection of cylindrical elements comprised of an inner fiber lumen for media perfusion, the fiber wall through which oxygen can diffuse, and an annular region of hepatocytes surrounding the fiber. The primary non‐dimensional parameters that describe the system are: (i) the Peclet number, Pe, which is the ratio of convective oxygen transport through the lumen to diffusive oxygen transport to the fiber walls; (ii) the hepatocyte saturation parameter, θ, which is the ratio of the inlet oxygen partial pressure to the Michaelis‐Menten half‐rate oxygen partial pressure; (iii) the Thiele modulus, φ2, which is the ratio of oxygen consumption rate to oxygen diffusion rate in the hepatocyte annulus; (iv) the hepatocyte permeability ratio, β31, which is the ratio of oxygen permeability in the hepatocyte cell mass to oxygen permeability in the perfusing lumen medium; and (v) the hepatocyte annular thickness, ρ3, which is the ratio of the exterior hepatocyte annular radius to the fiber lumen radius. Only Pe and θ are easily manipulated operating variables. φ2, β31, and ρ3 are engineering design parameters that are set when a bioreactor is fabricated. The model results are expressed as the effective hepatocyte utilization ratio, Vratio, which is the ratio of the observed oxygen consumption rate to the intrinsic hepatocyte oxygen consumption rate. Large regions of Vratio > 0.9, which is deemed an acceptable effective hepatocyte utilization are found for parameter values consistent with standard hollow fiber cartridges used in bioartificial liver fabrication. The extent of the Vratio > 0.9 region increases to a plateau with increasing Pe, increases with increasing θ, decreases with increasing φ2, increases with increasing β31, and decreases with increasing ρ3. The theoretical results indicate that Vratio > 0.9 is found whenever the experimentally observed fractional oxygen consumption from the perfusing medium, , is less than 0.25. Combination of the theoretical and experimental results indicate that intrinsic, per cell oxygen consumption in the hollow fiber system may decrease as hepatocyte cell density increases and that this decrease may be due to lower intrinsic oxygen requirements in denser suspensions and not due to diffusion limitations in oxygen transport in the hollow fiber system as might be expected from two‐dimensional, monolayer culture oxygen consumption measurements.
Development of Cultivated Mucosal Epithelial Sheet Transplantation for Ocular Surface Reconstruction
Authors: Kinoshita Shigeru , Nakamura Takahiro
Published: December 2004

Abstract:  Regenerative medicine via tissue engineering is a newly developed medical field based on the use of somatic stem cells to generate biological substitutes and improve tissue functions. The achievement of these objectives depends on two important factors: stem cells, which are high in proliferability and differentiability, and the substrates that support them. In order to reconstruct the ocular surface in patients with severe ocular surface diseases, we decided to investigate the feasibility of human amniotic membrane as an epithelial carrier, and found that denuded amniotic membrane was the most appropriate substrate for this purpose. To develop the surgical treatment using denuded amniotic membrane as a carrier, we established the tissue engineering system for making transplantable epithelial sheets of either corneal or oral mucosal epithelial cells for ocular surface reconstruction.
Cell‐based Therapy to Regenerate Myocardium: from Bench to Bedside
Authors: Tomita Shinji
Published: December 2004

Abstract:  The field of cell‐based therapy to regenerate myocardium has been expanding rapidly, with significant advances being made in both the laboratory and the clinical area. In this article we review this field, including our experiences and discuss remaining issues and possibilities for future clinical applications.
Bioartificial Pancreas Research in Japan
Authors: Iwata Hiroo , Simada Hideki , Fukuma Eisai , Ibii Takahisa , Sato Hideki
Published: December 2004

Abstract:  The bioartificial pancreas (BAP), a medical device enclosing insulin‐secreting cells in a semipermeable membrane, is expected to physiologically control glucose levels, and thus to be able to inhibit development of serious chronic complications in diabetic patients. In this brief review, we introduce research activities on the development of the BAP in Japan, including membrane preparation for the BAP, evaluation of in vitro and in vivo BAP functions, and challenges for production of insulin‐secreting  cells  from  stem  cells.
Recent Progress of Vascular Graft Engineering in Japan
Authors: Matsuda Takehisa
Published: December 2004

Abstract:   The development of a small‐diameter vascular graft has long been awaited. This review covers research activities, achievements and progress on vascular engineering in Japan, which was conducted over the last decade. The article includes recently developed experimental scaffolds, biologically active artificial extracellular matrices (ECMs) or non‐fouling synthetic coatings, cell sourcing including the autologous vascular cell type, endothelial progenitor cells and genetically‐engineered, temporary endothelial‐like cells. The discussions were presented from biomechanical, biomaterial, cellular and tissue aspects. Once the mechano‐biological and biologically active extracellular milieus are established in a designed vascular graft, the functional, structural and mechanical tissue morphogenesis and adaptation of implanted vascular grafts may proceed with implantation duration, and the spatio‐temporal tissue modulations at cytokine, cellular, ECM levels under physiological stress proceed to regenerate vascular tissue architecture. The ultimate solution to a small‐diameter vascular graft should be realized by optimal combinations of these factors.
International Center for Medical Technologies Acknowledges Artificial Organ Pioneers at the ASAIO–ISAO Joint Congress in 2003
Authors: Nosé Yukihiko , Phillips Steven , Harmison Lowell , DeBakey Michael E.
Published: December 2004

Abstract:  The International Center for Medical Technologies (ICMT), a museum for artificial organs in Houston, Texas, officially opened in November 2002, as previously published in Artificial Organs 2003;27(9):821–32. The museum expanded its original activities to formulate the International Academy for Artificial Organ Pioneers (Academy) and the International Faculty for Health and Medical Technologies (Faculty). At the joint American Society for Artificial Internal Organs (ASAIO) and International Society for Artificial Organs (ISAO) Congress in Washington, DC on June 18, 2003, Yukihiko Nosé introduced the ICMT and its formulation. The activities and future perspectives were presented by the ICMT Museum Director, Steven Phillips; the Academy Dean, Lowell Harmison; and the Faculty Dean, Michael E. DeBakey.
Ocular changes, risk markers for eye disorders and effects of cataract surgery in elderly people: a study of an urban Swedish population followed from 70 to 97 years of age
Authors: Bergman Birgitta , Nilsson‐Ehle Herman , Sjöstrand Johan
Published: December 2004

Aims:  To investigate the prevalence of and potential risk factors for ocular disorders and the effects of timing of cataract surgery from age 70–97 years.

Population:  A representative population sample taken from within the Gerontological and Geriatric Population Studies (H 70) in Gothenburg, Sweden (n = 958). All subjects underwent eye examinations at age 70 years in 1971 and subsequently at ages 82, 88, 95 and 97 years. All inhabitants of Gothenburg aged 95 and 97 years were invited to participate in the study.

Results:  Decreased vision (visual acuity ≤  0.5) was found in 20% and 80% of subjects at ages 82 and 97 years, respectively. Blood folate and physical activity at age 70 years correlated positively and body mass index (BMI) negatively to visual acuity (VA) ≥  0.8 at ages 82 and 88 years. Smoking at age 70 years correlated to early age‐related maculopathy (ARM). Cataract surgery had been performed in 40% of subjects at age 97 years. Surgery 2 years earlier led to a 15% increase in time spent with improved vision.

Conclusions:  The deterioration of vision in elderly people is a major health problem, for which ‘low’ folate status, smoking, ‘high’ BMI and low physical activity are potential risk factors. Early cataract surgery is also beneficial in very old patients.
Evaluation of toxicity due to vital stains in isolated rat retinas
Authors: Tokuda Kazuhiro , Tsukamoto Teruhisa , Fujisawa Shigeki , Matsubara Masao
Published: December 2004

Purpose:  We investigated whether artificial aqueous humours are adequate incubation media compared with artificial cerebrospinal fluid (aCSF), and evaluated the retinal toxicity of two vital stains − trypan blue (TB) and indocyanine green (ICG) − and triamcinolone acetonide (TA) using isolated rat retinas incubated in artificial aqueous humours.

Methods:  In experiment 1, retinal segments were isolated and incubated in aCSF, BSS plus®, Opeguard® Neo Kit, or phosphate‐buffered saline (PBS). In experiment 2, retinal tissues were exposed to one of the agents and incubated in BSS plus®. Retinal damage was assessed by morphological examination and biochemical assay, which measured lactate dehydrogenase (LDH) in the medium once every hour.

Results:  In experiment 1, BSS plus® was confirmed as a suitable incubation medium. In experiment 2, there were no significant changes in the retinas exposed to TB or TA. Tissues exposed to ICG showed damage in every retinal layer and significantly higher release of LDH.

Conclusion:  Exposure to ICG caused retinal damage in isolated rat retina tissue in our experimental model (in vitro).
Activated protein C resistance in anterior ischaemic optic neuropathy
Authors: Nagy Valeria , Facsko Andrea , Takacs Lili , Balazs Erzsebet , Berta Andras , Balogh Istvan , Edes Istvan , Czuriga Istvan , Pfliegler Gyorgy
Published: December 2004

Purpose:  Protein C is a major component of the natural anticoagulant pathway. Resistance of coagulation factor V (FV) to activated protein C (APC), mostly due to FV Leiden mutation, is the most common cause of inherited thrombophilia. The aim of this retrospective study was to determine the prevalence of APC resistance and Leiden mutation in patients with non‐arteritic anterior ischaemic optic neuropathy (NAION).

Methods:  A total of 25 patients with NAION were examined between 1997 and 2002. The patients were screened for APC resistance and FV Leiden mutation as well as for acquired risk factors of vascular disease such as diabetes mellitus, hypercholesterolaemia, hypertonia and ischaemic heart disease. A control group of subjects without ocular vascular disease and with homogenous distribution of the same risk factors was used for comparison.

Results:  Six of the 25 patients (24%) with NAION had APC resistance due to the heterozygous Leiden mutation of FV. The frequency of the same genetic mutation in the control group was only 5.9%. Odds ratio calculations showed that patients with the Leiden mutation were at a significantly higher risk of NAION than control patients (p ≤ 0.021).

Conclusion:  The high frequency of Leiden mutation in NAION suggests a pathogenic role of the mutation in the disease.
Optical coherence tomography in the diagnosis of juvenile X‐linked retinoschisis
Authors: Eriksson Urban , Larsson Eva , Holmström Gerd
Published: December 2004

Purpose:  To describe the value of optical coherence tomography (OCT) as a diagnostic tool in the diagnosis of X‐linked retinoschisis.

Methods:  We report three boys aged between 8 and 17 years, diagnosed with X‐linked retinoschisis. During investigations they were examined with OCT (Zeiss Humphrey OCT 1, upgraded version). Single scans of the central posterior pole and the region around the vascular arcades were obtained. Two of the boys underwent full‐field ERG according to ISCEV standards. Genetic analysis was performed in all three boys, with sequencing of the XLRS gene.

Results:  The OCT results revealed a pattern with a cleavage of the retina in two distinct planes, one deep (outer retina) and one superficial. This was very obvious in one patient and a similar but not as pronounced pattern was seen in the other two cases. The two layers were superficially connected with thin‐walled, vertical palisades, separated by low reflective, cystoid spaces, confluent and most prominent in the foveal region.

Conclusion:  Full‐field ERG and/or DNA analysis are well known methods used for diagnosis of X‐linked juvenile retinoschisis. In this paper, we suggest that OCT can also be a helpful diagnostic tool.
Efficacy of early systemic betamethasone or cyclosporin A after corneal alkali injury via inflammatory cytokine reduction
Authors: Den Seika , Sotozono Chie , Kinoshita Shigeru , Ikeda Tsunehiko
Published: December 2004

Purpose:  To evaluate the effects of early systemic administration of betamethasone or cyclosporin A (CsA) on inflammatory cytokine expression and corneal damage after alkali injury.

Methods:  Sixty‐five Wistar rat corneas injured with 1N NaOH were divided into three groups: untreated, betamethasone‐treated and CsA‐treated. Both agents were administered systemically and daily during the first 7 days after injury. Interleukin (IL)‐1α, ‐6 and ‐8 concentrations in the injured corneas were measured with ELISA at 2, 4 and 7 days after injury. Corneal damage was evaluated by scoring clinical findings.

Results:  In untreated injured corneas, IL‐1α, ‐6 and ‐8 were markedly elevated during the 7‐day period following injury. Both betamethasone and CsA significantly suppressed IL‐1α and IL‐8 at day 4. Only betamethasone significantly suppressed IL‐6 at days 4 and 7. Both agents significantly reduced corneal opacity at day 4.

Conclusion:  Early systemic administration of betamethasone or CsA after alkali injury may be of benefit by suppressing inflammatory cytokine expression in the cornea.
Biglycan gene expression in UVR‐exposed rabbit corneas
Authors: Podskochy Alexander , Koulikovska Marina , Fagerholm Per , Van Der Ploeg Ingeborg
Published: December 2004

Purpose: It is known that stromal proteoglycans play an important role in the hydration and transparency of the mammalian cornea. Proteoglycans have been described as a pathological deposit in climatic proteoglycan stromal keratopathy, which is associated with chronic ultraviolet radiation (UVR) exposure. The expression of dermatan sulfate proteoglycan biglycan in the cornea was thus studied after exposure of rabbit eyes to UVR.

Methods: New Zealand albino rabbit corneas were exposed to UVR at 310 nm at the dose producing biomicroscopically significant keratitis (0.47 J/cm2). Animals were killed 3, 7 and 28 days after exposure (five rabbits in each group). Five rabbits were used as controls and did not receive any UVR treatment. Expression of biglycan mRNA in the corneas was investigated by competitive reverse transcription‐polymerase chain reaction (RT‐PCR).

Results: There was no expression of biglycan mRNA in the control group. In the UVR‐exposed groups, biglycan mRNA had still not been expressed 3 days after exposure. The expression of biglycan mRNA was observed in all UVR‐treated corneas 7 days after exposure (p < 0.05). By 28 days after UVR exposure the expression of biglycan mRNA had decreased (not statistically significant).

Conclusions: There is no detectable biglycan gene expression in the normal rabbit cornea. Ultraviolet radiation exposure leads to a distinct expression of biglycan mRNA in the rabbit cornea that decreases 4 weeks after exposure, indicating the involvement of biglycan in the corneal repair process. Biglycan appears to be a novel marker of corneal wound healing.
Evaluation of visual impairment in Usher syndrome 1b and Usher syndrome 2a
Authors: Pennings Ronald J. E. , Huygen Patrick L. M. , Orten Dana J. , Wagenaar Mariette , Van Aarem Annelies , Kremer Hannie , Kimberling William J. , Cremers Cor W. R. J. , Deutman August F.
Published: December 2004

Purpose:  To evaluate visual impairment in Usher syndrome 1b (USH1b) and Usher syndrome 2a (USH2a).

Methods:  We carried out a retrospective study of 19 USH1b patients and 40 USH2a patients. Cross‐sectional regression analyses of the functional acuity score (FAS), functional field score (FFS) and functional vision score (FVS) related to age were performed. Statistical tests relating to regression lines and Student's t‐test were used to compare between (sub)groups of patients. Parts of the available individual longitudinal data were used to obtain individual estimates of progressive deterioration and compare these to those obtained with cross‐sectional analysis. Results were compared between subgroups of USH2a patients pertaining to combinations of different types of mutations.

Results:  Cross‐sectional analyses revealed significant deterioration of the FAS (0.7% per year), FFS (1.0% per year) and FVS (1.5% per year) with advancing age in both patient groups, without a significant difference between the USH1b and USH2a patients. Individual estimates of the deterioration rates were substantially and significantly higher than the cross‐sectional estimates in some USH2a cases, including values of about 5% per year (or even higher) for the FAS (age 35−50 years), 3−4% per year for the FFS and 4−5% per year for the FVS (age > 20 years). There was no difference in functional vision score behaviour detected between subgroups of patients pertaining to different biallelic combinations of specific types of mutations.

Conclusions:  The FAS, FFS and FVS deteriorated significantly by 0.7−1.5% per year according to cross‐sectional linear regression analysis in both USH1b and USH2a patients. Higher deterioration rates (3−5% per year) in any of these scores were attained, according to longitudinal data collected from individual USH2a patients. Score behaviour was similar across the patient groups and across different biallelic combinations of various types of mutations. However, more elaborate studies, preferably covering longitudinal data, are needed to obtain conclusive evidence.
Assessment of chamber angle pigmentation during longterm latanoprost treatment for open‐angle glaucoma
Authors: Nakamura Yuko , Nakamura Yoshimi , Morine‐Shinjo Sayo , Sakai Hiroshi , Sawaguchi Shoichi
Published: December 2004

Purpose:  This study aimed to determine whether the longterm use of latanoprost is associated with an increase in trabecular pigmentation, especially in subjects in whom iris pigmentation has increased.

Methods:  We enrolled 50 subjects for whom treatment was to start for ocular hypertension, primary open‐angle glaucoma or normal tension glaucoma. All subjects received latanoprost 0.005% daily. Trabecular pigmentation was documented using gonioscopic photography of the inferior quadrant at baseline, every 3 months for the first year and every 6 months for the second and third years. Three glaucoma specialists evaluated the series of gonioscopic photographs for each eye of each subject in a masked fashion. The intraocular pressure (IOP) was also recorded at each visit.

Results:  A total of 41 subjects (79 eyes) completed 3 years of follow‐up, and none showed any increase in the grade of trabecular pigmentation, including 10 subjects (20 eyes) in whom the iridial pigment increased.

Conclusion:  Although latanoprost increased iridial pigmentation in some subjects, we found no evidence of an increase in trabecular pigmentation over the 3 years of follow‐up.
Acupuncture treatment in patients with keratoconjunctivitis sicca: a pilot study
Authors: Grönlund Marita Andersson , Stenevi Ulf , Lundeberg Thomas
Published: December 2004

Aim:  To evaluate the effects of acupuncture in patients with keratoconjunctivitis sicca (KCS).

Material and Methods:  Twenty‐five patients (20 women, five men) with KCS were randomly assigned to an acupuncture treatment group or a control group. The effects of acupuncture were evaluated by a questionnaire on symptoms, visual analogue scale recordings, registration of drop frequency, and dry eye tests. Ten acupuncture sessions were given. Follow‐up was carried out after 2–3 weeks and again after a mean period of 8 months.

Results:  Patients receiving acupuncture felt better at the first follow‐up compared with the control group (p = 0.036). However, no statistical significance could be found concerning any change, or difference, in the total number of subjective symptoms, dosage frequency or, as indicated by the dry eye tests, tear quality, tear secretion and ocular surface disease.

Conclusion:  The results indicate that acupuncture has subjective beneficial effects in patients with KCS and could therefore be tried as a complement to ordinary treatment.
Self‐tonometry with the Ocuton S: evaluation of accuracy in glaucoma patients
Authors: Sacu Stefan , Vass Clemens , Schemper Michael , Rainer Georg
Published: December 2004

Background:  To compare two methods of measuring intraocular pressure (IOP) and to evaluate whether repeated measurements taken with the Ocuton S applanation self‐tonometer can improve reliability.

Methods:  Ocuton S and Goldmann applanation tonometry (GAT), and corneal thickness measurements taken with the Orbscan topography system, were successfully performed in 64 of 68 glaucoma patients.

Results:  The median IOPs were 15.5 mmHg using GAT, and 16 mmHg using the first self‐taken Ocuton S measurement (n = 64). The differences between the median of the GAT measurements and the first Ocuton S measurement, and the medians of the three and six separate Ocuton S measurements were within 3 mmHg in 52%, 59% and 67% of cases, respectively. The mean corneal thickness of all evaluated eyes was 545.3 µm. There was no effect of corneal thickness on the accuracy of either of the two devices (p > 0.05).

Conclusion:  Repeated measurements can improve the reliability of the Ocuton S. However, even with repeated measurements only every second patient succeeds in obtaining reliable measurements.
Rosacea lymphoedema of the eyelid
Authors: Lai Tze Foon , Leibovitch Igal , James Craig , Huilgol Shyamala C. , Selva Dinesh
Published: December 2004

Purpose:  To present a patient with rosacea lymphoedema of one upper eyelid resulting in unilateral complete ptosis.

Methods:  A 51‐year‐old white man presented with a 12‐month history of progressive painless swelling of the left upper eyelid. An incisional biopsy of the upper eyelid was performed.

Results:  The biopsy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histiocytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicated a lymphoedematous manifestation of rosacea. The patient was treated with minocycline and prednisolone with no effect.

Conclusion:  Rosacea lymphoedema involving the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist.
Screening for diabetic retinopathy using a digital non‐mydriatic camera compared with standard 35‐mm stereo colour transparencies
Authors: Hansen Anja B. , Sander Birgit , Larsen Michael , Kleener Jørgen , Borch‐Johnsen Knut , Klein Ronald , Lund‐Andersen Henrik
Published: December 2004

Purpose:  To investigate the use of a digital non‐mydriatic camera for determining the ETDRS clinical level of diabetic retinopathy, and to evaluate its use in a screening setting to appropriately determine the need for referral to an ophthalmologist (ETDRS level ≥ 35).

Methods:  A total of 83 patients with diabetes were photographed with and without pharmacological pupil dilation at an ophthalmology department using a digital non‐mydriatic camera, obtaining two sets of five non‐stereoscopic, 45 degree field images of each eye. ETDRS seven standard field, 35‐mm stereoscopic colour fundus photographs were also obtained. A subgroup of 59 patients was photographed at an optician's shop using the digital non‐mydriatic camera without pupil dilation.

Results:  There was substantial agreement between the clinical level of diabetic retinopathy assessed from the 35‐mm photographs and the digital images: the ophthalmology department (κ = 0.76) with pupil dilation and (κ = 0.66) without pupil dilation, respectively, and at the optician's (κ = 0.60 without pupil dilation). With respect to the need for referral to an ophthalmologist, there was almost perfect agreement in the ophthalmology department (κ = 0.88) with pupil dilation and (κ = 0.84) without pupil dilation, respectively, and those taken at the optician's (κ = 0.87 without pupil dilation).

Conclusion:  A digital non‐mydriatic camera may be used in a screening situation to appropriately determine the need for referral to an ophthalmologist (ETDRS level ≥ 35).
Neuro‐ophthalmological findings in sarcoidosis
Authors: Heuser Kjell , Kerty Emilia
Published: December 2004

Purpose:  This review emphasizes the importance of neuro‐ophthalmological signs and symptoms in sarcoidosis. The presence of ophthalmological and neuro‐ophthalmological findings may lead to diagnosis of the disease and the initiation of adequate treatment.

Material and Methods:  Patients who had been diagnosed with neurosarcoidosis during the period 1990 − 2001 were identified from the departmental diagnostic index. The history, clinical, laboratory and imaging data of patients were analysed.

Results:  Fifteen patients were identified, four men and 11 women, with a mean age of 44.1 years (range 26–65 years). In six of the 15 (40%), neurological deficits were the initial symptoms. Nine (60%) had known sarcoidosis at the time of presentation. Ten patients (66%) had ophthalmological/neuro‐ophthalmological symptoms and signs.

Conclusion:  Neuro‐ophthalmological symptoms may develop early in neurosarcoidosis. If neuro‐ophthalmological symptoms arise in patients with established biopsy‐proven sarcoidosis, the diagnosis is usually easy to make. However, a number of patients with neurosarcoidosis may present with neuro‐ophthalmic symptoms before systemic involvement becomes obvious. In this situation the diagnosis is challenging, and the major goal is to establish the presence of systemic sarcoidosis.
Diabetic retinopathy screening using digital non‐mydriatic fundus photography and automated image analysis
Authors: Hansen Anja B. , Hartvig Niels V. , Jensen Maja S. , Borch‐Johnsen Knut , Lund‐Andersen Henrik , Larsen Michael
Published: December 2004

Purpose:  To investigate the use of automated image analysis for the detection of diabetic retinopathy (DR) in fundus photographs captured with and without pharmacological pupil dilation using a digital non‐mydriatic camera.

Methods:  A total of 83 patients (165 eyes) with type 1 or type 2 diabetes, representing the full spectrum of DR, were photographed with and without pharmacological pupil dilation using a digital non‐mydriatic camera. Two sets of five overlapping, non‐stereoscopic, 45‐degree field images of each eye were obtained. All images were graded in a masked fashion by two readers according to ETDRS standards and disagreements were settled by an independent adjudicator. Automated detection of red lesions as well as image quality control was made: detection of a single red lesion or insufficient image quality was categorized as possible DR.

Results:  At patient level, the automated red lesion detection and image quality control combined demonstrated a sensitivity of 89.9% and specificity of 85.7% in detecting DR when used on images captured without pupil dilation, and a sensitivity of 97.0% and specificity of 75.0% when used on images captured with pupil dilation. For moderate non‐proliferative or more severe DR the sensitivity was 100% for images captured both with and without pupil dilation.

Conclusion:  Our results demonstrate that the described automated image analysis system, which detects the presence or absence of DR, can be used as a first‐step screening tool in DR screening with considerable effectiveness.
Screening for diabetic retinopathy in Denmark: the current status
Authors: Hansen Anja Bech , Andersen Mads Varis Nis
Published: December 2004

Purpose:  To investigate the current status of screening for diabetic retinopathy in Denmark, focussing on organization, methods of screening and regional differences.

Methods:  A questionnaire was sent out in 2002 to 14 departments of ophthalmology and one ophthalmology practice, covering all 15 counties in Denmark.

Results:  Six counties reported having systematic screening, defined as organized screening, including a database; three reported having plans for systematic screening; two reported having undetermined plans for systematic screening and four reported having no plans for systematic screening. In counties with systematic screening, both the organization and the method of screening varied.

Conclusion:  Approximately 43% of Danish patients with diabetes currently live in a county without systematic screening for diabetic retinopathy. Should all counties contemplating systematic screening implement their plans, this proportion will be reduced to approximately 17%.