bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunological Effects of Allopurinol in the Treatment of Experimental Autoimmune Uveitis (EAU) after Onset of the Disease
Authors: Grus F.H. , Augustin A.J. , Loeffler K. , Lutz J. , Pfeiffer N.
Published: January 2018

Purpose

Allopurinol reduces oxidative tissue damage and exerts immunomodulating effects in the treatment of experimental autoimmune uveitis (EAU). However, the mechanism of the immunologic pathway remains unclear. In previous studies, treatment was started at the time of immunization. Therefore, whether allopurinol prevents the onset of the disease (i.e., acts in a protective manner) is not known.

Methods

Sixteen male Lewis rats were used: 6 EAU without therapy [control]; 4 EAU with allopurinol treatment starting 7 days after immunization [AL7]; and 6 EAU with allopurinol treatment starting 11 days after immunization [AL11]. Their sera were tested against Western blots of sodium dodecyl sulfate-polyacrylamide gel electrophoresis of retinal proteins. Based on digital image analysis, analysis of discriminance was done.

Results

There were significant immunomodulating effects in both therapy groups (Wilks' lambda 0.001, P<0.008) compared to controls. However, the effects were more pronounced in the AL7 group, where peak intensities and the number of peaks were markedly more reduced.

Conclusions

Immunomodulating effects of allopurinol can be detected even if the therapy starts after the onset of the disease. Thus allopurinol strongly influences the immunologic mechanism in this model of autoimmune disease. In view of its minimal side effects, the drug could be a promising alternative for the therapy and prophylaxis of uveitis and other autoimmune diseases.
Organized Vitreous Hemorrhage Masquerading as an Optic Disc Melanocytoma
Authors: Puri P. , Prasad S. , Rennie I.G.
Published: January 2018

Purpose

To present a case of organized vitreous hemorrhage masquerading an optic disc melanocytoma.

Discussion

Optic nerve head melanocytoma is a benign slightly pigmented lesion arising from the edge of the disc presenting with a filed defect. Pigmented nature of the lesion in question due to presence of haemosidrin laden macrophages led a diagnostic dilemma. Trans vitreal biopsy confirmed the diagnosis.

Conclusions

Althought classical in presentation organized blood clots can masquerade a number of lesions including a melanocytoma as in the present scenario.
Central Retinal Vein Occlusion Risk Profile: A Case-Control Study
Authors: Shahsuvaryan M.L. , Melkonyan A.K.
Published: January 2018

Purpose

To identify risk factors for central retinal vein occlusion (CRVO).

Methods

This clinic-based case-control study included 408 patients with CRVO aged 21 years and older and 566 controls who were seen between January 1, 1990, and December 31, 2001. Multivariate logistic regression analysis was used to adjust for various factors and test potential interactions between the different variables.

Results

An increased risk of CRVO was found in persons with systemic hypertension, but odds ratios were greater for older patients. Risk of CRVO increases with age and also in association with hypercoagulability. Diabetes mellitus, kidney disease, and glaucoma were associated with increased risk for CRVO. A significantly greater prevalence of higher erythrocyte sedimentation rate was present in young adults compared with older patients.

Conclusions

The results suggest a relationship between CRVO and certain risk factors (systemic hypertension, diabetes mellitus, kidney disease, glaucoma, older age) and support the possibility of an association between CRVO and urban location. The findings also support the potential value of medical treatment of underlying medical conditions in preventing occurrence of CRVO.
Sjögren Reticular Dystrophy of the Retinal Pigment Epithelium: A Case Report
Authors: Rinaldi M. , Villani A. , Borrelli M. , Russo S. , Cotticelli L.
Published: January 2018

Purpose

To describe the clinical manifestations in a patient with Sjögren reticular dystrophy of the retinal pigment epithelium, and the evolution of the disease over a 20-year follow-up period.

Case Report

A 45-year-old woman with Sjögren reticular dystrophy of the retinal pigment epithelium was seen for the first time in 1983; the patient underwent 20 years of annual check-ups.

Results

Over the follow-up period, fundus photographs, computerized perimetry, electroretinogram, and electro-oculogram findings had either normal or slightly subnormal outcome.

Conclusions

The results confirm that this disease involves only the retinal pigment epithelium and should not be considered a central tapeto-retinal degeneration or late onset retinopathy.
Changes in Medical and Surgical Treatments of Glaucoma between 1997 and 2000 in France
Authors: Baudouin C. , Rouland J-.F , Le Pen C.
Published: January 2018

Purpose

To analyze quantitative changes in glaucoma treatment strategies between 1997 and 2000 in France.

Methods

Numbers of ab externo trabeculectomies and other glaucoma surgeries were extracted from the national database of the French Diagnosis Related Group system, which includes data for both public and private hospitals. Mean lengths of stay and hospital costs were estimated using national cost scales published by the French Ministry of Health. Numbers of patients treated per year with latanoprost, brimonidine, or the fixed combination of dorzolamide + timolol were estimated from drug unit sales using defined daily doses for each drug.

Results

Between 1997 and 2000, the number of patients treated with a glaucoma drug increased from 410,000 to 734,000 patients per year. This increase was associated with the introduction of three new glaucoma drugs: 245,000 patients received latanoprost (71.0%), brimonidine (28.8%), or the fixed combination of dorzolamide + timolol (0.2%). During the same period, the surgery rate in patients receiving medical treatment declined by 47%, from 5.9% to 3.1%. The total number of glaucoma interventions declined by 4.6% (-12% in public hospitals and 0% in private hospitals). This relative stability resulted mostly from a shift from trabeculectomies to other procedures, mainly to new filtering procedures in private hospitals.

Conclusions

Between 1997 and 2000, new glaucoma drugs, primarily latanoprost and brimonidine, improved intraocular pressure control and delayed surgery, reducing the glaucoma procedure rate in patients receiving glaucoma-related medical treatment by 47%.
Glaucoma among Omani Diabetic Patients: A Cross-Sectional Descriptive Study (Oman Diabetic Eye Study 2002)
Authors: Khandekar R. , Zutshi R.
Published: January 2018

Purpose/Methods

A cross-sectional study was carried out to review the ocular status of 2,063 diabetic patients in Oman. A part of this study is presented to highlight the magnitude and determinants of glaucoma. The study also recommends policies for comprehensive care of glaucoma among diabetic patients. The ocular pressure, disc changes, and field changes were noted by ophthalmologists. The diabetes profile was noted by physicians.

Results

The rate of glaucoma among diabetic patients was 8.87% (95% CI 8.12 to 9.62). Male diabetic patients had significantly higher rates of glaucoma than female diabetic patients. The rate was significantly higher in higher age groups. The mean ocular pressure in glaucomatous eyes was 28.6 mm Hg. The rate was not significantly different in patients with type I and type II diabetes (RR 1.03 [95% CI 0.61 to 1.79]). The risk of visual disability was higher among diabetic patients with glaucoma than diabetic patients without glaucoma (RR 1.56 [95% CI 1.14 to 2.13]).

CONCLUSIONS

Ocular pressure measurement could be a simple and reliable first-level screening tool. Diabetic patients with glaucoma should be given special care to reduce visual disability. All patients with diabetes should be thoroughly checked periodically to rule out glaucoma.
Entropion Uveae: Early Sphincter Atrophy, Signposting Primary Angle Closure Glaucoma?
Authors: Sihota R. , Saxena R. , Agarwal H.C.
Published: January 2018

Purpose

An easily recognized clinical marker for early changes of primary angle closure glaucoma (PACG) or eyes predisposed to angle closure is important so that timely laser iridotomy can prevent morbidity. Pupillary ruff changes, specifically appearance of entropion uveae (EU), are frequent in eyes with PACG.

Methods

Pupillary ruff was examined under magnification and EU, if present, was graded and correlated with gonioscopic grading and presence of peripheral anterior synechiae (PAS) in consecutive patients with primary open angle glaucoma (POAG), non-glaucomatous controls, and PACG of the subacute, acute, chronic symptomatic, and creeping angle closure glaucoma subgroups.

Results

No POAG eye had an abnormal pupillary ruff. A total of 86.7% of subacute PACG eyes and all eyes with acute and chronic PACG showed some grade of EU. Iridocorneal synechiae were more significantly correlated with EU than goniosynechiae (p<0.001). Meridian of iridocorneal but not iridotrabecular synechiae could be correlated with the meridian of EU. In age-matched patients EU was only present in eyes with steep iris configuration, with significant correlation with narrow angles and goniosynechiae. In the detection of PACG the presence of EU Grade I was 94.9% sensitive and 98.2% specific for PACG eyes compared to the gonioscopic picture of angle closure in occludable angles. Its positive predictive value was 91.4%.

Conclusions

EU shows significant correlation with narrow angles, steep iris configuration, and PAS. Kinking of radial iris arteries during angle closure probably causes temporary ischemia, especially of end arteries supplying area of the pupil and sphincter pupillae. EU emerges as an easily observed, objective marker for PACG.
Bilateral Congenital Macular Coloboma in a Boy with down Syndrome
Authors: Hayasaka Y. , Hayasaka S.
Published: January 2018

Purpose

To describe macular coloboma in Down syndrome.

Methods

A 12-year-old boy with Down syndrome underwent ophthalmologic examination.

Results

The patient had a circumscribed, round defect about 1 disc diameter, with bared sclera at the base and pigment clump at the macula in both fundi. His poor visual acuity was unchanged since childhood. The results of serum IgG and IgM titers for Toxoplasma gondii were negative.

Conclusions

Congenital macular coloboma associated with Down syndrome, as demonstrated in our patient, may not have occurred by chance.
Cystoid Macular Edema Associated with Latanoprost after Uncomplicated Cataract Surgery
Authors: Altintaş Ö. , Yüksel N. , Karabaş V.L. , Demìrcì G.
Published: January 2018

Purpose

To report clinically symptomatic and angiographically documented cystoid macular edema (CME) associated with the use of latanoprost in two pseudophakic eyes after uncomplicated cataract surgery.

Methods

Retrospective review of two patients who had history of latanoprost use and uncomplicated cataract surgery and described blurred vision in the first postoperative month.

Results

Ocular examination revealed CME, which was confirmed by fluorescein angiography. The visual acuities of patients improved and the CME was angiographically resolved after discontinuation of latanoprost and the initiation of nonsteroidal anti-inflammatory eye-drops and oral acetazolamide.

Conclusions

Until a causal relationship between CME and latanoprost is proved or disproved, caution in its use in pseudophakic patients would be prudent.
Cataract Surgery Combined with Intravitreal Injection of Triamcinolone Acetonide
Authors: Jonas J.B. , Kreissig I. , Budde W.M. , Degenring R.F.
Published: January 2018

Purpose

To evaluate whether the addition of cataract surgery to an intravitreal injection of triamcinolone acetonide markedly increases frequency and spectrum of complications.

Methods

The comparative nonrandomized clinical interventional investigation included a study group of 60 eyes (56 patients) undergoing cataract surgery and additionally receiving an intravitreal injection of about 20 mg of triamcinolone acetonide and a triamcinolone control group of 290 eyes (262 patients) that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide without cataract surgery. Reasons for intravitreal injection of triamcinolone acetonide were exudative age-related macular degeneration (n = 228; 65%), diffuse diabetic macular edema (n = 94; 27%), central retinal vein occlusion (n = 17; 5%), and branch retinal vein occlusion (n = 11; 3%). Mean follow-up was 8.6±6.8 months. A second control group included 1068 patients (1068 eyes) who consecutively underwent routine cataract surgery without intravitreal injection.

Results

Study group and triamcinolone control group did not vary significantly in best visual acuity during follow-up (p=0.08), final visual acuity at the end of follow-up (p=0.30), maximal intraocular pressure during follow-up (p=0.99), frequency of an intraocular pressure higher than 21 mmHg (p=0.66), and intraocular pressure at the end of follow-up (p=0.06). Postoperative infectious endophthalmitis, wound leakage or other corneal wound healing problems, persisting corneal endothelial decompensation, rhegmatogenous retinal detachment, marked postoperative pain, or a clinically significant decentration of the intraocular lens were not observed. Study group and the non-triamcinolone control group did not vary significantly in the rate of posterior lens capsule rupture (p=0.11), postoperative infectious endophthalmitis, and persisting postoperative corneal endothelial decompensation.

Conclusions

The addition of cataract surgery to an intravitreal injection of triamcinolone acetonide may not markedly increase amount and frequency of side effects and complications of intravitreal triamcinolone acetonide. No safe conclusions can be reached regarding differences in frequency of postoperative infectious endophthalmitis.
Paraneoplastic Optic Neuropathy in a Patient with a Non-Small Cell Lung Carcinoma: A Case Report
Authors: Asproudis I.C. , Nikas A.N. , Psilas K.G.
Published: January 2018

Purpose

To report a case and describe the clinical approach to a patient with a non-small cell lung carcinoma and paraneoplastic optic neuropathy.

Methods

Case report.

Results

A 79-year-old woman with known non-small cell lung carcinoma was admitted with a swollen optic disc in the right eye. After detailed clinical, laboratory, and imaging studies, the authors diagnosed paraneoplastic optic neuropathy, excluding other possible diagnosis.

Conclusions

Paraneoplastic optic neuropathy is a clinical challenge and should be considered as a possible diagnosis in every cancer patient with optic disc edema.
Reproducibility of Optic Nerve Head Measurements Obtained by Optical Coherence Tomography
Authors: Olmedo M. , Cadarso-Suarez C. , Gomez-Ulla F. , Val C. , Fernandez I.
Published: January 2018

Purpose

To evaluate reproducibility of optic nerve head (ONH) morphometry measurements obtained by optical coherence tomography (the fast optical disk protocol of the Zeiss model 3000 OCT system) in normal and glaucomatous eyes.

Methods

Prospective instrument-evaluation study. ONH measurements for 20 eyes were obtained in eight scan sessions taken during two visits to an ophthalmology clinic (10 normal patients, 10 glaucoma patients, one eye per subject). At every one of the eight sessions for each eye, estimates of eight ONH morphometry variables (see Main outcome measures) were obtained. The first two sessions were performed by two operators, followed by a 30-minute break. The same operators then completed a third and fourth session. This sequence was duplicated on a second visit. Intrasession, intersession, intervisit, and interoperator reproducibility of the eight variables were calculated by the use of a components variance model. Intraclass correlation coefficients (ICC) were used to assess reliability.

Results

Vertical integrated rim area, horizontal integrated rim area, disk area, cup area, rim area, cup/disk area ratio, cup/disk horizontal ratio, cup/disk vertical ratio. With the exception of the horizontal integrated rim area and rim area in normal subjects, the factor subject was the most important source of variance for all variables. Reliability values as measured by ICC for normal eyes were above 81%, with the exception of measurements of the horizontal integrated rim area (23.1%), rim area (33.3%), and disk area (64.7%). For glaucomatous eyes all values were above 85%, with the exception of the disk area (68.1%).

Conclusions

ONH measurements obtained using the fast optical disk protocol of the Zeiss 3000 OCT system show good reproducibility, for both normal and glaucomatous eyes.
Prospective Randomized Study Determining Whether a 3-Day Application of Ofloxacin Results in the Selection of Fluoroquinolone-Resistant Coagulase-Negative Staphylococcus
Authors: Ta C.N. , He L. , Nguyen E. , De Kaspar H. Miño
Published: January 2018

Purpose

To determine whether a 3-day application of ofloxacin results in the selection of fluoroquinolone-resistant conjunctival coagulase-negative Staphylococcus.

Design.

Prospective randomized trial.

Methods

Patients scheduled for ocular surgery were randomized to a control (89 eyes) or study group (70 eyes). The study group received topical ofloxacin (0.3%) four times a day for 3 days. Conjunctival cultures were obtained at baseline (T0) and after 3 days of ofloxacin (T1). Cultures were also obtained at T0 and T1 for the control group, but these eyes did not receive an antibiotic. Bacteria isolated were identified and antibiotic susceptibility was determined.

Results

At T0, 53 out of 89 patients (60%) in the control and 48 out of 70 patients (69%) in the study group harbored coagulase-negative Staphylococcus. Among these coagulase-negative Staphylococcus, 12 out of 53 in the control and 11 out of 48 in the study group were resistant to ofloxacin (p>0.9999). At T1, significantly fewer coagulase-negative Staphylococcus (p=0.0003) were isolated from the study group (18 coagulase-negative Staphylococcus), compared the control group (48 coagulase-negative Staphylococcus). Of these, 5 out of 17 coagulase-negative Staphylococcus in the study group and 9 out of 48 coagulase-negative Staphylococcus in the control group were resistant to ofloxacin (p=0.5649). There was no significant difference in the number of coagulase-negative Staphylococcus resistant to ciprofloxacin or norfloxacin in the study group compared to the control group at T1.

Conclusions

Ofloxacin given four times a day for 3 days does not select out for conjunctival fluoroquinolone-resistant coagulase-negative Staphylococcus.
Allergy and Infections: Long-Term Improvement of Vernal Keratoconjunctivitis following Viral Conjunctivitis
Authors: Sgrulletta R. , Bonini S. , Lambiase A. , Bonini S.
Published: January 2018

Purpose

Vernal keratoconjunctivitis (VKC) is a severe, chronic allergic inflammatory disease of the ocular surface poorly responsive to antiallergic treatments and possibly leading to permanent visual impairment. VKC, because of mast cell, eosinophil, and Th2-type inflammation, polyclonal IgE activation, and tissue remodeling, is considered to be a typical Th2-driven disease. Viral infection stimulates a Th1 type immune response, potentially attenuating allergen-induced inflammation. The purpose of this report is to describe the effect of viral keratoconjunctivitis in a patient with VKC.

Methods

The authors report on a patient with a severe form of VKC, poorly responsive to antiallergic treatments, who developed a viral keratoconjunctivitis. Signs, symptoms, and cytologic findings were recorded during the 5-year follow-up period.

Results

The authors observed a prompt and permanent improvement of signs and symptoms of the allergic condition after the viral infection. Conjunctival scraping confirms that the inhibition of the eosinophilic inflammation lasts at least for 5 years.

Conclusions

In this case, the viral infection seemed to induce a clinical recovery of allergic disease, suggesting that an immune deviation induced by Th1-polarizing agents may revert an ongoing Th2 inflammation.
Impression Cytology of Melanocytic Conjunctival Tumors Using the Biopore Membrane
Authors: Keijser S. , Missotten G.S. , De Wolff-Rouendaal D. , Verbeke S.L.J. , Van Luijk C.M. , Veselic-Charvat M. , De Keizer R.J.W.
Published: January 2018

Purpose

To compare a new Biopore membrane impression cytology method with the routinely used exfoliative cytology in patients with a melanocytic lesion of the conjunctiva.

Methods

Sixty-eight consecutive patients with a conjunctival melanocytic lesion underwent Biopore membrane impression cytology as well as exfoliative cytology. A histologic sample was also available in 26 cases. All Biopore samples were stained immediately with RAL 555. Both Biopore and exfoliative cytology samples were assessed by two cytopathologists and graded into four different categories of atypia.

Results

Twenty-three out of 26 Biopores and 20 out of 24 for the exfoliative smears correlated with the corresponding histologic sample. Biopore cytology resulted in higher numbers of cells with a greater density compared to exfoliative cytology.

Conclusions

Biopore cytology can be used for cytologic sampling of conjunctival melanocytic lesions. Because of the larger amount and higher density of cells obtained with the Biopore membrane, interpretation by a pathologist is easier and faster. Sampling of the fornix, caruncula, and ocular material in children is difficult with the Biopore method, and exfoliative cytology seems to be the favorable test in those situations.
Neuroprotection: A Valuable Goal in Glaucoma Management?
Authors: Rossetti L.
Published: January 2018

Glaucoma is characterized by an accelerated loss of retinal ganglion cells, as a result of damage to optic nerve axons. One factor involved in the disease process is elevated intraocular pressure (IOP) and this is the current focus of therapies. However, up to 45% of patients experience glaucoma progression despite good IOP control and partly as a result, the treatment principle of direct neuroprotection has been developed, which consists of treating optic nerve degeneration in glaucoma independently of IOP lowering. Animal models have shown the potential of this approach but there are limited clinical trial data. Brimonidine and memantine currently show promise, in terms of efficacy and side effects, among the compounds entering clinical trials. Brimonidine has been shown to have a neuroprotective effect independent of IOP lowering in humans with glaucoma, and data from a large clinical trial are being analyzed. Memantine has shown neuroprotective effects in animal models of glaucoma, and data from a clinical trial in humans are awaited.
Treatment Carryover Impacts on Effectiveness of Intraocular Pressure Lowering Agents, Estimated by a Discrete Event Simulation Model
Authors: Denis P. , Le Pen C. , Umuhire D. , Berdeaux G.
Published: January 2018

Purpose

To compare the effectiveness of two treatment sequences, latanoprost–latanoprost timolol fixed combination (L-LT) versus travoprost–travoprost timolol fixed combination (T-TT), in the treatment of open-angle glaucoma (OAG) or ocular hypertension (OHT).

Methods

A discrete event simulation (DES) model was constructed. Patients with either OAG or OHT were treated first-line with a prostaglandin, either latanoprost or travoprost. In case of treatment failure, patients were switched to the specific prostaglandin-timolol sequence LT or TT. Failure was defined as intraocular pressure higher than or equal to 18 mmHg at two visits. Time to failure was estimated from two randomized clinical trials. Log-rank tests were computed. Linear functions after log-log transformation were used to model time to failure. The time horizon of the model was 60 months. Outcomes included treatment failure and disease progression. Sensitivity analyses were performed.

Results

Latanoprost treatment resulted in more treatment failures than travoprost (p<0.01), and LT more than TT (p<0.01). At 60 months, the probability of starting a third treatment line was 39.2% with L-LT versus 29.9% with T-TT. On average, L-LT patients developed 0.55 new visual field defects versus 0.48 for T-TT patients. The probability of no disease progression at 60 months was 61.4% with L-LT and 65.5% with T-TT.

Conclusions

Based on randomized clinical trial results and using a DES model, the T-TT sequence was more effective at avoiding starting a third line treatment than the L-LT sequence. T-TT treated patients developed less glaucoma progression.
Prognostic Factors Associated with Outcomes after Giant Retinal Tear Management Using Perfluorocarbon Liquids
Authors: Al-Khairi A.M. , Al-Kahtani E. , Kangave D. , Abu El-Asrar A.M.
Published: January 2018

Purpose

To identify prognostic factors for visual acuity and anatomic outcomes associated with giant retinal tear management using intraoperative perfluorocarbon liquids.

Methods

All patients with giant retinal tears without proliferative vitreoretinopathy (PVR) who underwent management with intraoperative perfluorocarbon liquids between 1994 and 2005 were re-viewed.

Results

The study included 115 patients (117 eyes), 93 (80.9%) males and 22 (19.1%) females, with a mean age of 30.3±15.2 years. Mean follow-up period was 29.7±26.7 months. Success rate with primary procedure was 78.6%, which increased to 94% with multiple surgeries. On univariate analysis, factors significantly associated with final visual acuity better than 20/200 included phakic/clear lens at presentation (p=0.0113), partial retinal detachment (p=0.0233), absence of all postoperative complications (p=0.0122), absence of recurrent retinal detachment (p=0.0406), and absence of postoperative PVR (p=0.0062). Logistic regression analysis highlighted that phakic/clear lens at presentation, unfolded flap of the giant tear, absence of postoperative cataract, and absence of post-operative PVR were associated with final visual acuity better than 20/200. On univariate analysis, use of gas tamponade was significantly associated with recurrent retinal detachment (p=0.0190). Logistic regression analysis highlighted that placement of an encircling scleral buckle and use of silicone oil tamponade were associated with anatomic reattachment with primary procedure.

Conclusions

Encircling scleral buckling and silicone oil tamponade decrease the risk of recurrent retinal detachment.
Comparison of Visual Function and Ocular Hemodynamics between Pre- and Post-Menopausal Women
Authors: Siesky B.A. , Harris A. , Patel C. , Klaas C.L. , Harris M. , McCranor L.J. , Lauer J. , Kaplan B.
Published: January 2018

Purpose

The incidence of eye disease increases with age and can often be linked to worsening cardiovascular function and increasing intraocular pressure. Estrogen is known to have vasodilatory effects in the systemic circulation. Decreased estrogen levels during menopause may therefore complicate or contribute to ocular pathologies as estrogen receptors are found in both retinal and choroidal tissue. The purpose of this investigation was to determine the effects of menopause on visual function and cardiovascular and ocular hemodynamics.

Methods

Twelve premenopausal and 24 postmenopausal women were evaluated at the Indiana University School of Medicine during a single study visit. Vision screening and ocular blood flow evaluations were performed, including blood pressure, heart rate, visual acuity, contrast sensitivity, intraocular pressure, and retinal capillary and retrobulbar blood flow imaging. Vision and ocular hemodynamics were compared using unpaired Student t-tests with pp<0.05 regarded as statistically significant.

Results

The premenopausal group had significantly lower heart rate (-16.1 b/m, p=0.0001) and systolic blood pressure (-17.7 mmHg, p=0.003) than postmenopausal subjects. Contrast sensitivity was significantly higher (measured in log units) in premenopausal women in both the right (0.25, p=0.039; 0.16, p=0.039) and left (0.45, p=0.001; 0.27, p=0.032) eyes at 9 and 18 cycles per degree, respectively. Premenopausal women also had significantly lower intraocular pressure in both the right (-2.19 mmHg, p=0.024) and left (-1.74 mmHg, p=0.035) eyes. Total ocular perfusion was not significantly different between groups.

Conclusions

This pilot work suggests that postmenopausal women have lower contrast sensitivity detection and elevated intraocular pressures compared to premenopausal women. Premenopausal women have lower cardiovascular risk factors, while total ocular circulation was similar to post-menopausal women.
Long-Term Results of a Suture Burial Technique
Authors: Baykara M. , Timucin O.B.
Published: January 2018

Purpose

To report the long-term (minimum 24 months of follow-up) results of a scleral suture fixation technique.

Methods

Surgical databases from one surgeon were reviewed for consecutive cases from March 2003 to August 2005 in which the scleral suture fixation technique was used and a minimum follow-up of 24 months was completed. In this study, by knotting the suture onto itself, the author has buried the end and the knot of the suture into the sclera for scleral fixation, to stay put within the sclera. Intraoperative technical complications, postoperative visual outcomes, intraocular pressures, and suture-related complications were evaluated for each patient.

Results

A total of 150 scleral-sutured free suture ends were evaluated after a minimum 24 months of follow-up in 75 eyes of 75 patients. No technical or suture-related complications (suture exposure, irritation, granulomas, giant papillary conjunctivitis, suture abscess) were recorded throughout the follow-up period.

Conclusions

Long-term follow-up of the suture burial technique - which allows avoidance of scleral incision, flap, or tunnel formation, as well as patch grafts for scleral fixation of intraocular lenses - showed it to be safe and effective.
Confocal Microscopic Evidence of Increased Langerhans Cell Activity after Corneal Metal Foreign Body Removal
Authors: Resch M.D. , Imre L. , Tapasztó B. , Németh J.
Published: January 2018

Purpose

The purpose of the study was to examine the corneal inflammatory reaction and Langerhans cells with confocal microscopy after metal foreign body removal.

Methods

Corneal metal foreign body was removed from 9 eyes of 9 consecutive patients 12.1±13.6 (4 to 72) hours after superficial angle grinder injury. Both eyes were examined with the Heidelberg Retina Tomograph II (HRT II) Rostock Cornea Module. Morphology and density of epithelium, nerves, metal deposits, keratocytes, endothelium, and Langerhans cells were compared to the uninjured fellow eyes (controls).

Results

Irregularity and partially missing superficial epithelium was found in all cases. Around the area of injury prolonged basal and wing epithelial cells were found in all eyes. The basal epithelium density is lower than in the control eye (p=0.043). Density of Langerhans cells (68.1±24.2/mm2) was increased in the epithelium, compared to controls (35.2±21.8/mm2, p=0.012). Keratocyte and endothelium densities were not different from that of controls. Some keratocytes showed signs of activation and the inhomogeneous background reflectivity revealed extracellular matrix alterations. Inflammatory reaction was observed up to 260 μm depth. The metal foreign body particles had high reflectivity and irregular edge.

Conclusions

In vivo confocal microscopy provided additional information to biomicroscopic signs such as epithelial damage and inflammation. It showed the effects of metal foreign bodies in the cornea: nerve damage and Langerhans cell density increase. Langerhans cells seem to play an important role in the inflammatory response after corneal foreign body injuries.
Treatment of Peripapillary Choroidal Neovascularization with Intravitreal Bevacizumab
Authors: Hoeh A.E. , Schaal K.B. , Ach T. , Dithmar S.
Published: January 2018

Purpose

Peripapillary choroidal neovascularization (CNV) is an uncommon condition and often shows a growth tendency towards the fovea during spontaneous progression that threatens visual acuity. Treatment of peripapillary CNV is difficult. The authors report results of intravitreal bevacizumab therapy for peripapillary CNV.

Methods

Four patients with CNV located in the temporal or superior peripapillary area received intravitreal bevacizumab injections. Ophthalmologic examinations including OCT were performed at baseline and at 6-week intervals. Fluorescein angiography was performed at baseline and depending on clinical and OCT findings. The mean follow-up was 34±20 (22–69) weeks.

Results

The patients received an average of 3.5±3.1 (1–8) injections. In all patients fluorescein angiography showed inactivation of peripapillary CNV. No further increase in size was observed in any of the patients. The OCT showed a decrease of intraretinal and subretinal fluid. No intraocular or systemic side effects were observed.

Conclusions

In this series of patients, intravitreal bevacizumab appears to be efficacious. A progression of peripapillary CNV could be prevented in all patients and the lesion was successfully inactivated. Anti-VEGF treatment with bevacizumab represents a promising therapy option for peripapillary CNV.
A new curriculum to address dementia-related stigma: Preliminary experience with Alzheimer’s Association staff
Authors: Herrmann Lynn K. , Udelson Nancy , Kanetsky Cheryl , Liu Hongyan , Cassidy Kristin , Welter Elisabeth , Sajatovic Martha
Published: January 2018

Objective

Develop and test a stigma awareness and education curriculum targeted to non-medical staff of a local Alzheimer’s Association chapter.

Methods

The curriculum, developed in collaboration with leadership and educational staff from the Cleveland Chapter of the Alzheimer’s Association, included a definition, types, and domains of stigma; effects of stigma on individuals with dementia and their families; stigma evaluation studies; tips to address the topic of dementia-related stigma with individuals and families. Lastly, an interactive discussion of real-life scenarios facilitated stigma recognition and management.

Results

Most staff felt the training improved their ability to identify Alzheimer’s disease stigma, made them more comfortable talking about stigma, and would change the way they interacted with people and families impacted by Alzheimer’s disease.

Conclusions

This brief, practical educational curriculum has potential to improve awareness of dementia stigma in Alzheimer’s Association staff. Research is needed to expand stigma awareness in individuals and groups with varying levels of dementia knowledge.
Barriers and Enablers to the Implementation of School Wellness Policies: An Economic Perspective
Authors: Schuler Brittany R. , Saksvig Brit I. , Nduka Joy , Beckerman Susannah , Jaspers Lea , Black Maureen M. , Hager Erin R.
Published: January 2018

Background. Local wellness policies (LWPs) are mandated among school systems to enhance nutrition/physical activity opportunities in schools. Prior research notes disparities in LWP implementation. This study uses mixed methods to examine barriers/enablers to LWP implementation, comparing responses by student body income. Method. Schools ( n = 744, 24 systems) completed an LWP implementation barriers/enablers survey. Semistructured interviews ( n = 20 random subsample) described barriers/enablers. Responses were compared by majority of lower (≥50% free/reduced-price meals; lower income [LI]) versus higher income (HI) student body. Results. In surveys, LI and HI schools identified common barriers (parents/families, federal/state regulations, students, time, funding) and enablers (school system, teachers, food service, physical education curriculum/resources, and staff). Interviews further elucidated how staffing and funding served as enablers for all schools, and provide context for how and why barriers differed by income: time, food service (HI schools), and parents/families (LI schools). Conclusions. Findings support commonalities in barriers and enablers among all schools, suggesting that regardless of economic context, schools would benefit from additional supports, such as physical education and nutrition education resources integrated into existing curricula, additional funding, and personnel time dedicated to wellness programming. LI schools may benefit from additional funding to support parent and community involvement.
A Network Meta-Analysis on the Diagnostic Value of Different Imaging Methods for Lymph Node Metastases in Patients With Cervical Cancer
Authors: Luo Qian , Luo Lan , Tang Liang
Published: January 2018

Purpose:

We performed this network meta-analysis to compare the diagnostic value of 4 imaging methods (magnetic resonance imaging, positron emission tomography, computed tomography, and diffusion-weighted imaging) for diagnosing lymph node metastases in cervical cancer.

Method:

Diagnostic tests regarding different imaging methods to diagnose lymph node metastases in cervical cancer were retrieved from the Cochrane Library, PubMed, and Embase electronic databases from inception to December 2016. Direct and indirect evidence was performed to calculate the odds ratio and to draw the surface under the cumulative ranking curves of the 4 imaging methods for diagnosing lymph node metastases in cervical cancer.

Results:

Sixteen eligible diagnostic tests were included in this network meta-analysis. The results of network meta-analysis demonstrate that in comparison with the diffusion-weighted imaging, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of positron emission tomography were relatively higher. Additionally, the results further indicate that compared with other diagnosis method, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of positron emission tomography had a higher trend. The surface under the cumulative ranking curve results indicated that in terms of positive likelihood ratio and diagnostic odds ratio, positron emission tomography had a relatively higher diagnostic value for lymph node metastases in patients with cervical cancer.

Conclusion:

Our findings indicate that positron emission tomography might have a relatively higher diagnostic value for lymph node metastases in patients with cervical cancer.
Lapatinib Inhibits Breast Cancer Cell Proliferation by Influencing PKM2 Expression
Authors: Guan Mingxiu , Tong Yingna , Guan Minghua , Liu Xiaobin , Wang Meng , Niu Ruifang , Zhang Fei , Dong Dong , Shao Jie , Zhou Yunli
Published: January 2018

Pyruvate kinase type M2, which is expressed in multiple tumor cell types and plays a key role in aerobic glycolysis, also has nonglycolytic functions and can regulate transcription and cell proliferation. The results of this study show that epidermal growth factor receptor activation induces pyruvate kinase type M2 nuclear translocation. To further determine the relationship between pyruvate kinase type M2 and epidermal growth factor receptor, we analyzed pathological data from mammary glands and performed epidermal growth factor receptor/human epidermal growth factor receptor 2 knockdown to reveal that pyruvate kinase type M2 is associated with epidermal growth factor receptor and human epidermal growth factor receptor 2. Lapatinib is a small molecule epidermal growth factor receptor tyrosine kinase inhibitor that can inhibit epidermal growth factor receptor and human epidermal growth factor receptor 2, though its effect on pyruvate kinase type M2 remains elusive. Accordingly, we performed Western blotting and reverse transcription polymerase chain reaction and analyzed pathological data from mammary glands, with results suggesting that lapatinib inhibits pyruvate kinase type M2 expression. We further found that the antitumor drug lapatinib inhibits breast cancer cell proliferation by influencing pyruvate kinase type M2 expression, as based on Cell Counting Kit-8 analyses and pyruvate kinase type M2 overexpression experiments. Signal transducer and activator of transcription 3, which is a transcription factor-associated cell proliferation and the only transcription factor that interacts with pyruvate kinase type M2, we performed pyruvate kinase type M2 knockdown experiments in Human breast cancer cells MDA-MB-231 and Human breast cancer cells SK-BR-3 cell lines and examined the effect on levels of Signal transducer and activator of transcription 3 and phosphorylated Signal transducer and activator of transcription 3. The results indicate that pyruvate kinase type M2 regulates Signal transducer and activator of transcription 3 and phospho-Stat3 (Tyr705) expression. Together with previous reports, our findings show that lapatinib inhibits breast cancer cell proliferation by influencing pyruvate kinase type M2 expression, which results in a reduction in both Signal transducer and activator of transcription 3 and phosphorylated Signal transducer and activator of transcription 3.
Differential expression of cytokeratin 14 and 18 in bladder cancer tumorigenesis
Authors: Li Yun-Peng , Jia Xiao-Peng , Jiang Yu-Qing , Wang Wei , Wang Yun-Liang , Wang Xiu-Li , Guo Yue-Xian
Published: January 2018

It has been previously suggested that cytokeratins (CKs) are important diagnostic and prognostic biomarkers for urothelial lesions. Hence it is imperative to understand the expression pattern of cytokeratins during formation of papillary bladder cancer, which was the objective of the current study. Expression pattern of CK14 and CK18 were examined using immunohistochemical staining in a mice model of papillary bladder cancer. Twenty female mice were divided into two groups—group 1 (NT) and group 2, which received N-butyl- N-(4-hydroxybutyl) nitrosamine (BBN) for 20 weeks plus one week without treatment. Following histological classification of bladder lesions, CK14 and CK18 immunostaining was assessed according to its distribution and intensity. In NT animals, both basal cells and umbrella cells showed sporadic positive staining for CK14 and CK18, respectively. In BBN group, hyperplastic lesions showed significantly more CK14 and significantly less CK18 staining ( P < 0.05 in each case). Invasive carcinomas showed increased CK14 immunostaining in all epithelial layers. Cumulatively, our data indicate that altered CK14 (high) and CK18 (low) expression is perhaps an early event in bladder cancer tumorigenesis in females at least and is characteristic of both urothelial superficial pre-neoplastic and neoplastic lesions.

Impact statement

Studies have shown that expression of cytokeratins (CKs) or their altered distribution affects the bladder cancer pathogenesis and disease outcome, while the underlying mechanisms are not clear. The present study aims to explore the expression pattern of CK14 and CK18 during formation of papillary bladder cancer. The results showed that hyperplastic lesions showed significantly more CK14 and significantly less CK18 staining and invasive carcinomas showed increased CK14 immunostaining in all epithelial layers in N-butyl- N-(4-hydroxybutyl)nitrosamine (BBN)-induced mouse model. The results indicate that altered CK14 (high) and CK18 (low) expression is perhaps an early event in bladder cancer tumorigenesis and is characteristic of both urothelial superficial pre-neoplastic and neoplastic lesions, which may provide the early diagnosis index.
A smooth tool path generation and real-time interpolation algorithm based on B-spline curves
Authors: Sun Shujie , Yu Dong , Wang Changhui , Xie Chuanning
Published: January 2018

In the machining progress of free-form surface, tool path is presented as continuous small line segments. To achieve high machining speed and fine machining quality, the tool path needs to be smoothed. This study presents a smooth tool path generation algorithm based on B-spline curves for small line segments machining. The algorithm includes two modules: smooth tool path generation module and real-time look-ahead interpolation module. In the smooth tool path generation module, the tool path is divided into non-fitting regions and fitting regions by three conditions: the length of small line segments, the angle of adjacent small line segments, and the change rate of the length and angle. To control contour error and get fine machining quality, the fitting regions are corrected by circle correction method and fitted into B-spline curves, while the non-fitting regions are smoothed with B-spline curves. In this module, the gained tool path has continuous curvature. In the interpolation module, the seven-phase jerk-limited look-ahead planning is adopted to generate smooth machining velocity, while the calculation accuracy of interpolation point generated by the interpolation period crossing two adjacent tool path is controlled. Simulations and experimental results demonstrate that the proposed algorithm is able to reduce the amount of numerical control codes, achieve high machining speed, and improve machining quality.
A study on the effect of main process parameters of rotary ultrasonic machining for drilling BK7 glass
Authors: Anwar Saqib , Nasr Mustafa M , Pervaiz Salman , Al-Ahmari Abdulrahman , Alkahtani Mohammed , El-Tamimi Abdulaziz
Published: January 2018

BK7 glass is an important engineering material with extensive applications in high-quality and precision transmissive optical components. However, BK7 glass is considered to be a difficult-to-cut material due to its high brittleness and nonconductivity. This article presents the use of rotary ultrasonic machining process for drilling holes in BK7 glass. No previous reports have been found in the literature to experimentally investigate the response of the BK7 glass to rotary ultrasonic drilling. The experimental investigations take into account the effect of the key rotary ultrasonic machining input parameters including the ultrasonic power, spindle speed and feed rate on the output responses of cutting force, exit chipping, surface roughness, hole cylindricity and overcut errors, and surface integrity. The results show that the input parameters within the current ranges can significantly affect the quality of the drilled holes. Moreover, the selected level of any input parameter has the ability to significantly affect the influence of the other input parameters on the output responses. Through proper selection of input parameters, holes could be drilled in BK7 glass with less fractured topography, low surface roughness (1.32 µm), low exit chipping size (0.85), and very low cylindricity (3 µm) and overcut (73.6 µm) errors.
Genomic Instability on hMSH2, hMLH1, CD48 and IRF4 Loci in Pulmonary Sarcoidosis
Authors: Demopoulos K. , Arvanitis D.A. , Vassilakis D.A. , Siafakas N.M. , Spandidos D.A.
Published: January 2018

Pulmonary sarcoidosis shares certain features with immune disease and neoplasia, and microsatellite DNA alterations are detectable in sputum specimens of pulmonary sarcoidosis patients. The biological basis and significance of these findings remain obscure, while information regarding the genetic basis of the disease is limited. Using multiplex PCR-based microsatellite analysis, we investigated 40 markers located on 1p, 1q, 2p, 2q, 3p, 5q, 6p, 7p, 9p, 11q, 14q and 17p in 38 sputum specimens of pulmonary sarcoidosis patients. Loss of heterozygosity (LOH) was found in 13 of 38 (34.2%) patients in at least one locus. These alterations occurred in the subset of markers located in or close to DNA mismatch repair (MMR) genes, hMSH2 (2p22.3–p16.1) and hMLH1 (3p21.32–p21.1), as well as in CD48 (1q21–q23) and IRF4 (6p23–p25), genes associated with lymphocyte activation. Microsatellite instability (MIN) was observed in five cases (13.2%) in at least one locus. Our data suggest that genomic instability in pulmonary sarcoidosis could be due to MMR defects, while alterations of lymphocyte-specific agents could account for granuloma formation.