bluuebunny/crossref_metadata_2025 huggingface dataset:
Arithmetic difficulties in children with cerebral palsy are related to executive function and working memory
Authors: Jenks Kathleen M. , De Moor Jan , Van Lieshout Ernest C.D.M.
Published: May 2009

Background:  Although it is believed that children with cerebral palsy are at high risk for learning difficulties and arithmetic difficulties in particular, few studies have investigated this issue.

Methods:  Arithmetic ability was longitudinally assessed in children with cerebral palsy in special (n = 41) and mainstream education (n = 16) and controls in mainstream education (n = 16). Second grade executive function and working memory scores were used to predict third grade arithmetic accuracy and response time.

Results:  Children with cerebral palsy in special education were less accurate and slower than their peers on all arithmetic tests, even after controlling for IQ, whereas children with cerebral palsy in mainstream education performed as well as controls. Although the performance gap became smaller over time, it did not disappear. Children with cerebral palsy in special education showed evidence of executive function and working memory deficits in shifting, updating, visuospatial sketchpad and phonological loop (for digits, not words) whereas children with cerebral palsy in mainstream education only had a deficit in visuospatial sketchpad. Hierarchical regression revealed that, after controlling for intelligence, components of executive function and working memory explained large proportions of unique variance in arithmetic accuracy and response time and these variables were sufficient to explain group differences in simple, but not complex, arithmetic.

Conclusions:  Children with cerebral palsy are at risk for specific executive function and working memory deficits that, when present, increase the risk for arithmetic difficulties in these children.
A typology of reviews: an analysis of 14 review types and associated methodologies
Authors: Grant Maria J. , Booth Andrew
Published: May 2009

Background and objectives:  The expansion of evidence‐based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains.

Methods:  Following scoping searches, an examination was made of the vocabulary associated with the literature of review and synthesis (literary warrant). A simple analytical framework—Search, AppraisaL, Synthesis and Analysis (SALSA)—was used to examine the main review types.

Results:  Fourteen review types and associated methodologies were analysed against the SALSA framework, illustrating the inputs and processes of each review type. A description of the key characteristics is given, together with perceived strengths and weaknesses. A limited number of review types are currently utilized within the health information domain.

Conclusions:  Few review types possess prescribed and explicit methodologies and many fall short of being mutually exclusive. Notwithstanding such limitations, this typology provides a valuable reference point for those commissioning, conducting, supporting or interpreting reviews, both within health information and the wider health care domain.
Potential of Fortified Fibrin/Hyaluronic Acid Composite Gel as a Cell Delivery Vehicle for Chondrocytes
Authors: Park Sang‐Hyug , Cui Ji Hao , Park So Ra , Min Byoung‐Hyun
Published: May 2009

Numerous treatment methods have been applied for use in cartilage repair, including abrasion, drilling, and microfracture. Although chondrocyte transplantation is the preferred treatment, it has some shortcomings, such as difficulty of application (large and posterior condylar regions), poor chondrocyte distribution, and potential cell leakage from the defect region. The cell delivery system of the tissue engineering technique can be used to overcome these shortcomings. We chose fibrin/hyaluronan (HA) composite gel as an effective cell delivery system to resolve these issues. Both components are derived from natural extracellular matrix. In the first trial, fortified fibrin/HA composite gels with rabbit chondrocytes were tested by implantation in nude mice. At 4 weeks, glycosaminoglycan contents in the fibrin/HA composite (0.186 ±  0.006 mg/mg) were significantly higher than those in the presence of fibrin alone (0.153 ± 0.017 mg/mg). As a next step, we applied the fibrin/HA composite gel to animal cartilage defects using full thickness cartilage defect rabbit models. The fibrin/HA composite gel with rabbit chondrocytes (allogenic) was implanted into the experimental group, and the control group was implanted with the fibrin/HA composite gel alone. Implanted chondrocytes with the fibrin/HA composite showed improved cartilage formation. In conclusion, the key to successful regeneration of cartilage is to provide the repair site with a sufficient supply of chondrogenic cells with a suitable delivery vehicle to ensure maximal differentiation and deposition of the proper extracellular matrix. This study suggests the feasibility of tissue‐engineered cartilage formation using fibrin/HA composite gel.
Fragmin/Protamine Microparticle‐Coated Matrix Immobilized Cytokines to Stimulate Various Cell Proliferations With Low Serum Media
Authors: Kishimoto Satoko , Nakamura Shingo , Nakamura Shin‐ichiro , Kanatani Yasuhiro , Hattori Hidemi , Tanaka Yoshihiro , Harada Yasuji , Tagawa Masahiro , Mori Yasutaka , Maehara Tadaaki , Ishihara Masayuki
Published: May 2009

Abstract:  Fragmin/protamine microparticles (F/P MPs) have been shown to bind to culture plates, thereby retaining heparin‐binding cytokines. Most protocols for in vitro cultures of human microvascular endothelial cells (hMVECs), human dermal fibroblast cells (hDFCs), and hematopoietic cell line (TF‐1) include high fetal bovine serum (FBS) (10%) medium as a nutritional supplement. Growth rates of those cells on the F/P MP‐coated plates were higher in low FBS (1%) medium containing fibroblast growth factor (FGF)‐2 (for hMVECs and hDFCs) and interleukin (IL)‐3/granulocyte‐macrophage colony‐stimulating factor (for TF‐1 cells) than without coating. The cytokines in low FBS medium were shown to be immobilized on the F/P MP‐coated plate and released into the culture medium with a half releasing time of 4–5 days. Furthermore, those cells grew well on each cytokine‐preimmobilized F/P MP‐coated plate in low FBS medium. Thus, the F/P MP‐coated matrix with adequate heparin‐binding cytokines may provide biomaterials for controlling cellular growth and differentiation.
Design of an Artificial Left Ventricular Muscle: An Innovative Way to Actuate Blood Pumps?
Authors: Van Der Smissen Benjamin , Claessens Tom , Verdonck Pascal , Van Ransbeeck Peter , Segers Patrick
Published: May 2009

Blood pumps assist or take over the pump function of a failing heart. They are essentially activated by a pusher plate, a pneumatic compression of collapsible sacs, or they are driven by centrifugal pumps. Blood pumps relying upon one of these actuator mechanisms do not account for realistic wall deformation. In this study, we propose an innovative design of a blood pump actuator device which should be able to mimic fairly well global left ventricular (LV) wall deformation patterns in terms of circumferential and longitudinal contraction, as well as torsion. In order to reproduce these basic wall deformation patterns in our actuator device, we designed a novel kind of artificial LV “muscle” composed of multiple actively contracting cells. Its contraction is based on a mechanism by which pressurized air, inside such a cell, causes contraction in one direction and expansion perpendicular to this direction. The organization and geometry of the contractile cells within one artificial LV muscle, the applied pressure in the cells, and the governing LV loading conditions (preload and afterload) together determine the global deformation of the LV wall. Starting from a simple plastic bag, an experimental model based on the abovementioned principle was built and connected to a lumped hydraulic model of the vascular system (including compliance and resistance). The wall deformation pattern of this device was validated visually and its pump performance was studied in terms of LV volume and pressure and heart rate. Our experimental results revealed (i) a global LV motion resembling a real LV, and (ii) a close correlation between our model and a real LV in terms of end‐systolic volume and pressure, end‐diastolic volume and pressure, stroke volume, ejection fraction and pressure‐volume relationship. Our proposed model appears promising and it can be considered as a step forward when compared to currently applied actuator mechanisms, as it will likely result in more physiological intracavity blood flow patterns.
The Role of the Bcl‐3 Proto‐Oncogene in Thyroid Hormone‐Induced Liver Cell Proliferation
Authors: Malik Raza , Bungay Anton , Sadiq Amama , Brown David , Riemann Marc , Choudhury Sarah , Schmid Roland , Selden Clare , Hodgson Humphrey
Published: May 2009

The aim of the study was to determine if thyroid hormone‐induced liver cell proliferation occurs through the Bcl‐3 proto‐oncogene. Rodents (including Bcl‐3 knockout mice and the wild‐type strain) were injected with a single dose of tri‐iodothyronine (T3) and sacrificed at various time points. Hepatic mRNA (real‐time polymerase chain reaction ) and protein expression (Western analysis) of Bcl‐3 was quantified in rats stimulated with T3. Cell proliferation was induced in a variety of cell types after T3 injection at 24 h including hepatocytes (7 ± 1.1% vs. 0.45 ± 0.025%; P < 0.01), hepatic nonparenchymal cells (3.8 ± 1.2% vs. 0.3 ± 0.01%; P < 0.01), renal tubular cells (8.1 ± 1.6% vs. 0.2 ± 0.035%; P < 0.01), and splenic lymphocytes (4.8 ± 1.2% vs. 0.35 ± 0.02%; P < 0.01). We showed a twofold increase in hepatic Bcl‐3 mRNA (P < 0.01) and protein expression (P < 0.01) at 24 h in rats stimulated with T3. However, there were no differences in the rate of liver cell proliferation between Bcl‐3 knockout mice and the wild‐type strain (0.4 ±  0.15% vs. 0.3 ± 0.1%), indicating that Bcl‐3 was not functionally involved in thyroid hormone‐induced liver cell proliferation. A single gene is unlikely to initiate the process of thyroid hormone‐induced cell proliferation. A complex interaction between the genomic and nongenomic effects of thyroid hormone is likely to regulate the mitogenic effects.
A Randomized, Double Blind, Placebo‐Controlled Study of MAP0004 in Adult Patients With Migraine
Authors: Aurora Sheena K. , Rozen Todd D. , Kori Shashidhar H. , Shrewsbury Stephen B.
Published: May 2009

Background.— Dihydroergotamine mesylate (DHE) is an effective treatment for acute migraine, but its effective use is often limited by the inconvenience and inconsistency of intranasal, intramuscular, or subcutaneous routes of administration. A new formulation of DHE delivered through the lungs by the novel Tempo® inhaler is being developed and is designed to offer fast onset, consistent dosing, and sustained response.

Objective.— This proof of principle and dose setting study evaluated the efficacy and tolerability of inhaled DHE delivered by a breath‐synchronized, plume‐controlled inhaler (Tempo) in adult migraineurs.

Methods.— This was a randomized, double blind, placebo‐controlled, 2‐period study conducted at 9 headache centers in the United States. Adult men and women with a documented history of acute migraine for at least 12 months, with an average of 2 to 8 attacks per month in the preceding 6 months were treated with MAP0004 0.5 or 1.0 mg systemic equivalent dose (1.0 or 2.0 mg nominal dose) or matching placebo during Treatment Period 1 (TP1). Patients who responded to treatment during TP1 were re‐randomized in Treatment Period 2 (TP2) to receive MAP0004 0.25 mg systemic equivalent dose or placebo.

Results.— Of 86 patients randomized to treatment, 69 were included in the As‐Treated population in TP1. Pain relief at 2 hours was greater for MAP0004 0.5 mg (72%, P = .019) and 1.0 mg (65%, P = .071) than for placebo (33%). Pain relief at 10 (32%), 15 (46%), and 30 (55%) minutes was significantly (P < .05) greater with MAP0004 0.5 mg than with placebo (0%, 7% and 14%, respectively). Pain‐free at 2 hours was significantly greater with MAP0004 0.5 mg (44%, P = .015) and 1.0 mg (35%, P = .050) than with placebo (7%). Total migraine relief at 2 hours was significantly (P = .019) greater with MAP0004 0.5 mg (72%) than with placebo (33%). Sustained pain relief and pain‐free rates exhibited a therapeutic gain of 30% (P = .066) and 31% (P = .037) at 24 hours and 28% (P = .096) and 30% (P = .057) at 48 hours with MAP0004 0.5 mg vs placebo. MAP0004 was well tolerated with no serious or severe adverse events. Dysgeusia was reported as treatment‐related in 2 patients on placebo, 0 patients on MAP0004 0.5 mg, and 6 patients on MAP0004 1.0 mg. No clinically relevant changes were noted in spirometry, vital signs, electrocardiogram, or clinical laboratory values. No significant differences between treatments were observed in TP2.

Conclusions.— In this study MAP0004 0.5 mg and 1.0 mg were well tolerated and effective at delivering clinically significant, rapid, and sustained pain relief in adult migraine patients. No additional benefit was observed with the higher dose, thus the MAP0004 0.5 mg systemic equivalent dose has been selected as the dose for further clinical study.
Fixed‐Dose Sumatriptan and Naproxen in Poor Responders to Triptans With a Short Half‐Life
Authors: Mathew Ninan T. , Landy Stephen , Stark Stuart , Tietjen Gretchen E. , Derosier Frederick J. , White Jonathan , Lener Shelly E. , Bukenya Deo
Published: May 2009

Objective.— To evaluate efficacy and tolerability of a single, fixed‐dose tablet of sumatriptan 85 mg/naproxen sodium 500 mg (sumatriptan/naproxen sodium) vs placebo in migraineurs who had discontinued treatment with a short‐acting triptan because of poor response or intolerance.

Background.— Triptan monotherapy is ineffective or poorly tolerated in 1 of 3 migraineurs and in 2 of 5 migraine attacks. In April, 2008, the Food and Drug Administration approved the combination therapy sumatriptan/naproxen sodium, developed specifically to target multiple migraine mechanisms. This combination product offers an alternative migraine therapy for patients who have reported poor response or intolerance to short‐acting triptans.

Methods.— Two replicate, randomized, multicenter, double‐blind, placebo‐controlled, 2‐attack crossover trials evaluated migraineurs who had discontinued a short‐acting triptan in the past year because of poor response or intolerance. Patients were instructed to treat within 1 hour and while pain was mild.

Results.— Patients (n = 144 study 1; n = 139 study 2) had discontinued an average of 3.3 triptans before study entry. Sumatriptan/naproxen sodium was superior (P < .001) to placebo for 2‐ through 24‐hour sustained pain‐free response (primary end point) (study 1, 26% vs 8%; study 2, 31% vs 8%) and pain‐free response 2 hours post dose (key secondary end point) (study 1, 40% vs 17%; study 2, 44% vs 14%). A similar pattern of results was observed for other end points that evaluated acute (2‐ or 4‐hour), intermediate (8‐hour), or 2‐ through 24‐hour sustained response for migraine (ie, pain and associated symptoms), photophobia, phonophobia, or nausea (with the exception of nausea 2 and 4 hours post dose). The percentage of patients with at least 1 adverse event (regardless of causality) was 11% with sumatriptan/naproxen sodium compared with 4% with placebo in study 1 and 9% with sumatriptan/naproxen sodium compared with 5% with placebo in study 2. Only 1 adverse event in 1 study was reported in ≥2% of patients after treatment with sumatriptan/naproxen sodium and reported more frequently with sumatriptan/naproxen than placebo: chest discomfort was reported in 2% of subjects in study 1, and no events met this threshold in study 2. No serious adverse events attributed to study medication were reported in either study.

Conclusion.— In migraineurs who reported poor response to a short‐acting triptan, sumatriptan/naproxen sodium was generally well tolerated and significantly more effective than placebo in conferring initial, intermediate, and sustained efficacy for pain and migraine‐associated symptoms of photophobia and phonophobia.
A novel enzyme‐linked immunosorbent assay method for the detection of human neutrophil antigen‐2a antibodies
Authors: Bayat Behnaz , Werth Silke , Sachs Ulrich J. H. , Santoso Sentot
Published: May 2009

BACKGROUND: Antibodies to human neutrophil antigen (HNA)‐2a are responsible for a number of immune‐mediated neutropenia disorders. Although several methods exist for the identification of anti‐HNA‐2a, all these methods have several limitations. In this study, a solid‐phase enzyme‐linked immunosorbent assay (ELISA) using recombinant HNA‐2a antigen (rHNA‐2a) allowing rapid detection of HNA‐2a antibodies was developed.

STUDY DESIGN AND METHODS: Soluble rHNA‐2 was generated by transfection of insect cells with CD177 vector. Purified rHNA‐2a was immobilized on microtiter wells coated with anti‐CD177 and was applied to analyze 10 sera containing HNA‐2a antibodies. For the evaluation of the ELISA method, results were compared with the standard assay, MAIGA (monoclonal antibody antigen capture assay) for detection of neutrophil antibodies.

RESULTS: The specificity of HNA‐2a antibodies in all sera was confirmed by immunoblotting. Sera were then tested simultaneously in ELISA and MAIGA assays. Nine of 10 sera showed positive reactions in ELISA, whereas only 9 of 10 sera reacted in the standard MAIGA assay. All HNA‐2a antibodies were detectable in MAIGA when diluted sera were applied. No reaction was observed with different sera containing neutrophil‐reactive antibodies (6 anti‐HNA‐1a, 4 anti‐HNA‐1b, and 20 anti‐HLA Class I and II) in ELISA. All HNA‐2a antibodies were detectable in MAIGA when diluted sera were applied. Notably, sera containing anti‐proteinase 3 (PR3) from patients with Wegener's granulomatosis reacted in MAIGA. In contrast, this antibody showed no reaction in ELISA with purified rHNA‐2a.

CONCLUSIONS: These results demonstrated that ELISA with rHNA‐2a provides a good method for detecting HNA‐2a antibodies in human serum. This assay enables to exclude the presence of autoantibody against PR3 in patient's sera, which cannot be differentiated from anti HNA‐2a with current serologic methods.
Inactivation of pathogens in single units of therapeutic fresh plasma by irradiation with ultraviolet light
Authors: Mohr Harald , Gravemann Ute , Müller Thomas H.
Published: May 2009

BACKGROUND: Ultraviolet (UV) light, especially UVC, is germicidal but its ability to penetrate layers of protein containing solutions is poor. This hampers its use to inactivate pathogens in therapeutic fresh plasma (FP).

STUDY DESIGN AND METHODS: FP units were spiked with lipid‐enveloped or nonenveloped viruses. Others were used without spiking. The units were transferred into UV‐transparent bags and irradiated with UVB or UVC light from both sides. The bags either were clamped between quartz plates or remained loose. In addition they were agitated at different speeds. Before and after irradiation virus titers or plasma variables were measured.

RESULTS: Virus inactivation by UV irradiation was marginal when the FP units were not agitated or when the irradiation bags were fixed between quartz plates. It was strongly enhanced when they remained unfixed and were intensively agitated during treatment. At 100 rpm and UVC doses of approximately 1 J/cm2, with the exception of human immunodeficiency virus Type 1, all viruses used were effectively inactivated. UVB up to 2.5 J/cm2 was less effective. At 1 J/cm2 UVC or 2.5 J/cm2 UVB the activities of the clotting factors tested in general were reduced by approximately 10% to 20% compared to untreated plasma. More sensitive was clotting factor XI whose activity was lowered by approximately 23 and 29%, respectively. No further reductions were determined after storage of UVC‐treated FP for 3 months at 30°C or less.

CONCLUSIONS: Pathogen inactivation of FP by UV light becomes effective when the unfixed irradiation bags are strongly agitated. The decrease in some clotting factor activities could be acceptable.
In vitro measurement of corneal strain, thickness, and curvature using digital image processing
Authors: Hjortdal Jesper Ø. , Jensen Peter Koch
Published: May 2009

ABSTRACT A video camera, a microscope, and a PC‐based digital image processing board were assembled for in vitro studies of corneal biomechanics. Central tangential corneal strain was determined by placing pairs of tiny mercury droplets on the epithelial surface and on the endothelial surface of the cornea. A distance of 3.2 mm could be determined with a standard deviation of 1.2 μm. Central corneal radius of curvature was measured from digital traces of the corneal surface contour. The standard deviation on estimating the radius of an 8 mm steel sphere was 15 μm. Corneal thickness was measured by digital optical pachometry. The standard deviation on measuring a thickness of 1 mm was 4.6 μm. The corneal extensibility was investigated in a total of 10 enucleated human eyes with increased corneal hydration. Tension was applied by varying the intraocular pressure from 2 to 100 mmHg with a column of isotonic saline. The epithelial side corneal strain and the increase in corneal curvature were approximately 1% for a change in intraocular pressure from 2 to 100 mmHg. When a high intraocular pressure was kept constant for 2 h the corneal thickness, radius of curvature, and the epithelial side strain gradually decreased, whereas the endothelial side strain increased. The elastic and visco‐elastic behaviour of the human cornea was found to be closely related to changes in corneal hydration. We found digital image processing useful for in vitro biomechanical studies of the cornea.
Multiple myeloma presenting with bilateral exudative macular detachments
Authors: Brody Jill M. , Butrus Salim I. , Ashraf M. Farooq , Rabinowitz Andrew I. , Whitmore Paul V.
Published: May 2009

ABSTRACT Bilateral exudative macular detachments were present on a 64‐year‐old diabetic Caucasian male who presented with bilateral blurring of vision. Besides the exudative macular detachments there was no diabetic retinopathy or congestive retinopathy, and a previous fluorescein angiogram revealed no focal leakage. Laboratory investigation, bone marrow biopsy, and a bone survey revealed the diagnosis of multiple myeloma.
Dye laser treatment in proliferative diabetic retinopathy and maculopathy
Authors: Atmaca Leyla S. , Idil Aysun , Gündüz Kaan
Published: May 2009

ABSTRACT The aim of this study was to compare the efficacy of various dye laser wavelengths in different forms of retinopathies. The study material consisted of 292 eyes of 210 diabetic retinopathy patients treated with dye laser photocoagulation between 1990 and 1992. All the patients were followed for at least 6 months after photocoagulation. Nonproliferative changes (maculopathy and/or preproliferative retinopathy) were present in 135 (46.3%) and proliferative retinopathy in 157 (53.7%) of the eyes undergoing photocoagulation. Of the 157 eyes with proliferative retinopathy, 60 (20.5%) had disc neovascularization, 71 (24.3%) had retinal neovascularization and 26 (8.9%) had retinitis proliferans. Yellow dye laser (580 nm) was applied in 92 (31.5%) eyes, red dye laser (630 nm) in 120 (41.1%) eyes and both yellow and red dye lasers in 80 (27.4%) eyes. There was no significant difference between the different wavelength groups with regard to visual acuity changes before and after treatment (p<0.01). Overall, the visual acuity was maintained in 56.2% and improved in 25.0% of the eyes. After panretinal photocoagulation, disc neovascularization regressed partially or completely in 47 (78.3%) of the eyes. There was no significant difference among the various laser wavelengths with regard to treatment efficacy judged by the disappearance or regression of disc neovascularization (p<0.01). All retinal neovascularizations regressed completely with laser treatment, but in 7 eyes (9.9%) new retinal neovascularizations in previously untreated areas developed. Dye laser has not resulted in any complications. It requires lower power settings compared to argon laser and thus facilitates photocoagulation. Another advantage of dye laser is the ability to use yellow and red wavelengths sequentially.
Selenium concentrations in serum, lens and aqueous humour of patients with senile cataract
Authors: Karaküçük Sarper , Mirza G. Ertuǧrul , Ekinciler Ö. Faruk , Saraymen Recep , Karaküçük İnci , Üstdal Muzaffer
Published: May 2009

ABSTRACT Selenium (Se) is a trace element which incorporates into the selenoenzyme glutathion peroxidase. Cataractogenesis may be caused either by the excess or deficiency of this trace element. More recently, its potential of becoming a possible environmental pollutant has been emphasized. In an attempt to reveal the relationship of this element with cataractogenesis, we detected its level in 48 serum, 36 lens and 9 aqueous humour samples of 48 patients with senile cataract, comparing the results with appropriate controls. Selenium levels (mean ± SD) of cataractous patients were found to be 0.28±0.04 μg/ml (CI: 0.27 to 0.29 μg/ml) in sera (controls: 0.32±0.04 μg/ml; CI: 0.30 to 0.34 μg/ml, p<0.0001), 5.43±3.07 μg/g dry weight (CI: 4.43 to 6.43 μg/g dry weight) in lens (controls: 4.43±2.53 μg/g dry weight; CI: 2.78 to 6.08 μg/g dry weight; p=0.374) and 0.19±0.06 μg/ml (CI: 0.15 to 0.23 μg/ml) in aqueous humour samples (controls: 0.31±0.12 μg/ml; CI: 0.24 to 0.38 μg/ml, p=0.02). When patient subgroups were analyzed, serum Se levels were found to be 0.28±0.05 μg/ml (CI: 0.26 to 0.30 μg/ml) in the nuclear cataract and 0.28±0.02 μg/ml (CI: 0.27 to 0.30 μg/ml) in the cortical cataract. Lens Se levels, on the other hand, were detected as 5.91±3.56 μg/g dry weight (CI: 4.49 to 7.33 μg/g dry weight) in the nuclear cataract and 4.47±1.40 μg/g dry weight (CI: 3.68 to 5.26 μg/g dry weight) in the cortical cataract. It is anticipated that decreased Se in aqueous humour and sera of patients with senile cataract may reflect defective antioxidative defense systems which may lead to the formation of cataract.
Prognostic indicators following enucleation for posterior uveal melanoma
Authors: Seregard Stefan , Kock Erik
Published: May 2009

ABSTRACT Most previous reports on survival following enucleation for uveal malignant melanoma do not contain cumulative survival rates, do not use a multivariate approach and are liable to a considerable loss to follow‐up. In this study, the long‐term survival and tumour‐related mortality were studied in 340 patients. Archival specimens containing posterior uveal melanomas were initially examined and sectioned by one pathologist. There was no loss to follow‐up 6 to 22 years after enucleation. At the end of study, 233 (68.5%) individuals were dead; 137 (40.3%) of melanoma‐related causes and 96 (28.2%) of other causes. Melanoma‐related deaths appeared from 24 to 6848 days (18 years 8 months) after enucleation. The cumulative 5‐year survival proportion based on melanoma‐related deaths was 70% and the corresponding 10‐year proportion was 56%. Multivariate Cox regression indicated that the largest tumour dimension, cell type, and tumour location all had independent prognostic value, the associated hazard ratios ranged from 1.2 to 1.4, suggesting a moderate increase of the relative risk. Pair‐wise comparisons of the parameters indicated that large tumours were more common in the anterior choroid or ciliary body than in the posterior choroid. Similarly, large tumours were more often necrotic, composed of epitheloid cells, or featured extrascleral extension. Tumours with significant scleral invasion or extrascleral extension were more common in elderly patients.
Primary argon laser trabeculoplasty vs pilocarpine
Authors: Bergeå Bengt , Bodin Lennart , Svedbergh Björn
Published: May 2009

ABSTRACT In a prospective, randomized study on primary argon laser trabeculoplasty vs piloparpine in 82 newly detected open‐angle glaucomas the progress of optic nerve head damage is presented. In 70 patients reliable stereo photographs could be analysed. In the laser treated group a progression of glaucoma damage after 24 months was seen in 6/37 eyes (16%) and in the pilocarpine‐treated group 16/33 (49%) (p = 0.0048). There was a statistically significant favourable outcome if intraocular presssure was regulated in terms of peak and range of pressure, but not average pressure. This was even more pronounced in capsular glaucoma, but not significant for simple glaucoma. Pilocarpine increased the risk for further damage to the optic nerve head 6.4 times compared to laser trabeculoplasty. Thus, laser is recommended as the primary therapy in high tension glaucoma, especially in capsular glaucoma.
Reproducibility of the Glaucoma‐scope in cadaver eyes
Authors: Hamzavi Sirus , Stewart William C. , Jackson Galin J. , Thompson Teresa L.
Published: May 2009

ABSTRACT We evaulated the intra‐ and inter‐observer variability of depth measurements of the optic disc in cadaver eyes using the Glaucoma‐scope. Intra‐observer variation of 10 separately captured images became significantly greater with increasing depth of the optic cup (p < 0.001). The standard deviation of depth measurements were 9.06 μ over the neural rim, 25.00 μ along the cup wall, and 40.94 μ at the bottom of the optic cup. However, intra‐observer variation of a single captured image did not increase with greater optic cup depth. Intra‐observer variation, but not inter‐observer variation, generally was greater when measuring the superior than inferior optic disc (p<0.05). This study suggests that when capturing separate optic disc images with the Glaucoma‐scope, increased variation in depth measurements can be expected with greater optic cup depth and in the superior portion of the optic disc.
Aqueous shunts: Single‐plate Molteno vs ACTSEB
Authors: Kim Dong Myung , Lim Key Hwan
Published: May 2009

ABSTRACT A retrospective study was done to compare the results of the single‐plate Molteno implant surgery with those of the anterior chamber tube shunt to an encircling band procedure in eyes with refractory glaucoma. Both Molteno implant and anterior chamber tube shunt to an encircling band are made of silicone. There were 19 eyes in the Molteno group, 17 eyes in the anterior chamber tube shunt to an encircling band group, with at least 6 months of follow‐up. Preoperative intraocular pressure in the Molteno group and anterior chamber tube shunt to an encircling band group was 47.5 ± 11.4 and 46.5 ± 10.3 mmHg, respectively. Intraocular pressure at 6 months postoperatively was 20.4 ± 15.1 and 15.5 ± 10.4 mmHg, respectively. The difference in pressure reduction between the two groups was not significant statistically. Serious complication rate for 6 months was 11% and 47%, respectively.
Intraocular pressure elevation caused by massive and prolonged hemorrhage after trabeculotomy ab externo
Authors: Tanihara Hidenobu , Nakayama Yoshihito , Honda Yoshihito
Published: May 2009

ABSTRACT A case with postoperative elevated intraocular pressure levels caused by massive and prolonged hemorrhage after trabeculotomy ab externo is presented. In this case, intraocular pressure was controlled by removal of the hemorrhage, but the transient elevation resulted in progression of visual field defect. Thus, resorption of hyphema and intraocular pressure levels should be monitored closely after trabeculotomy, and surgical removal of the hemorrhage appears to be an effective treatment for this rare complication.
Myopia of adult onset
Authors: Fledelius Hans C.
Published: May 2009

ABSTRACT One hundred and fifty‐one adult subjects (age 26–64 years) with simple myopia (‘simple’ = absence of significant astigmatism and anisometropia) were asked about their myopia onset, here defined as the age when first having spectacles to correct vision trouble for distance. A precise memory appeared in 148. Usually, they could substantiate their information by detailed accounts regarding how and when. Evidently, the first pair of glasses is a strong emotional experience. Accordingly, information appears to be reliable when properly asking the patient. The sample confirmed established knowledge: the earlier the onset, the higher the final myopia. Adult onset myopia is usually low, but occasionally intermediate or high myopia cases are encountered. Adult onset myopia appears more frequently than evident from textbooks and literature on refractive distribution. A frequency estimate based on Danish material thus suggests that at least 25–30% of all adult age myopia is also of adult onset.
Myopia of prematurity, clinical patterns
Authors: Fledelius Hans C.
Published: May 2009

ABSTRACT A discussion of myopia of prematurity is based on 16 low‐birth weight children now aged 3 ‐ 9 years. During their first months after delivery, retinopathy of prematurity had been observed in all but one subject ‐ here possibly missed due to incomplete control. Two subjects had cryotherapy. Two eyes out of 32 got blind; another 4 eyes became weaksighted. The primary aim of the longitudinal study was to describe the variation in ‐ and the course of ‐ refraction, as apparent from serial examinations, the natural history so to say, to add new facets to our concept of myopia of prematurity and possibly to identify subgroups. Transient and fluctuating myopia being physiological in the first postnatal months, the diagnosis ‘myopia of prematurity’ should not be forwarded too early. Some cases of early myopia which did not regress as usual over the first 6 months, later showed a reduction in degree of myopia over 1 ‐ 2 years. Others pertained to the classical description of a stationary myopia, often of high degree, diagnosed in early childhood. Even in the favourable tail of the present distribution corrected visual acuity appeared subnormal according to age norms.
Do we have optimal screening limits in Sweden for vision testing at the age of 4 years?
Authors: Hård Anna‐Lena , Williams Penelope , Sjöstrand Johan
Published: May 2009

ABSTRACT The purpose of this study was to evaluate the Swedish screening criteria for referral of children to ophthalmic care after visual acuity testing at the age of 4 years. The screening limit has generally been 0.8. To what extent do children with 0.65 in each eye (0.65/0.65) or 0.65 in one and 0.8 in the other (0.65/0.8) at the age of 4 years have visual defects needing early treatment? Sixty‐three children who had failed screening underwent orthoptic and ophthalmologic evaluation. Twenty‐four patients (38%) saw 0.65/0.65 or 0.65/0.8 and were studied further. None of them had manifest strabismus. Refractive errors were minor except in 2 patients who had significant hyperopia. Twenty‐two of these 24 patients returned for reevaluation at the age of five years and that time 18 of them saw 0.8 or more without treatment. Our findings suggest that children with visual acuity of no less than 0.65 and no more than one line's difference between the eyes at 4 years of age seldom have visual defects needing treatment.
Handedness in strabismics
Authors: Firth Alison Y.
Published: May 2009

ABSTRACT The incidence of non right handedness was found to be significantly higher in a group of 228 strabismics when compared with a control group of neurologically normal non strabismic subjects. The difference was still present after elimination of strabismics with known neurological or general health problems, or who were born prematurely. The strabismics showed no inter group differences in handedness in relation to the type of retinal correspondence present or the ability to achieve normal or abnormal binocular single vision. Evidence is reviewed for the presence of a developmental defect leading to strabismus, and results of this survey support a previously proposed idea that a developmental defect leads to strabismus, the type of which reflects the severity of the defect (although external factors may also be an influence).
Screening for diabetic retinopathy
Authors: Kristinsson Jóhannes Kári , Gudmundsson Jóhann Ragnar , Stefánsson Einar , Jónasson Fridbert , Gíslason Ingimundur , Thórsson Árni V.
Published: May 2009

ABSTRACT A screening program for diabetic eye disease was established in Iceland in 1980. Diabetics involved in the screening program have a low prevalence of blindness, 1% in type 1 and 1.6% in type 2. We examined ways to make the screening program more efficient by identifying subgroups at low risk of developing eye disease that require treatment and therefore need less frequent screening. We studied whether diabetic eye disease screening programs may be trimmed by excluding children and examining diabetics without retinopathy biannually. Our results indicate that diabetic children under the age of 12 years do not need regular screening for eye disease. Biannual examinations seem to suffice in type 1 and 2 diabetic patients without retinopathy. However, in a setting where the eye clinic is located apart from the diabetes clinics, biannual examinations present practical problems which could result in a less effective screening for diabetic eye disease.
Bilateral simultaneous trabeculectomy
Authors: Thompson S. M. , Rokerya S.
Published: May 2009

ABSTRACT In this study the attitudes of experienced ophthalmologists to bilateral simultaneous trabeculectomy were canvassed using a postal questionnaire. Only 16% of respondents ever performed bilateral simultaneous trabeculectomy (BST). The main reason for not performing BST was fear of bilateral simultaneous complications. The notes of 95 patients who had undergone BST were reviewed. Post‐operative complications occurred in 41 eyes (43.6%) during the first post‐operative week, but only 8 patients (8.5%) had complications in both eyes. At 3 months post‐operatively, 5 patients (5.5%) had bilateral raised intraocular pressures with or without medication, and at 12 months this figure was 8 patients (9.3%). Twenty patients (21.3%) had a drop in visual acuity of two Snellen lines or more in both eyes at one week. At 3 months this figure was 5 patients (5.5%), and at 12 months 3 patients (3.5%) had lost two or more lines of vision in both eyes. Although BST is not commonly performed, the incidence of bilateral post‐operative complications is low.
Comparison of intraocular lenses from the standpoint of postoperative glare disability
Authors: Uchio Eiichi , Inamura Mikio , Ohno Shigeaki
Published: May 2009

ABSTRACT Although implantation of an intraocular lens provides excellent postoperative visual acuity, some factors such as disability glare have attached importance to qualitative evaluation of the visual function of artificial pseudophakia. In order to find out which factor most greatly contributed to glare disability, four types of intraocular lens, convexpiano, biconvex anterior more curved, posterior more curved, and equiconvex, were prospectively implanted. The patients were 21 men and 63 women, ranging in age from 39 to 92 years (mean ± SD = 70.9 ± 10.1 years). Glare disability, examined by the TitmusTM Miller‐Nadler Glare Tester, was found to be significantly correlated to types of intraocular lens, refractive power of intraocular lens, but not to age of patients or strength of postoperative astigmatism. The lower glare disability index value was found in patients implanted with posteriorly more curved biconvex or equiconvex surface, and within a range of 18.5–22D compared with those implanted with convex anterior or convex‐plano surface, and 22.5 D or more.
Protective effect of a specific PAF antagonist on vincristine‐induced experimental retinopathy
Authors: Doly Michel , Cluzel Jacques , Bonhomme Brigitte , Millerin Martine , Braquet Pierre
Published: May 2009

ABSTRACT The alkaloid vincristine displays considerable toxicity, particularly for the retina. This type of retinopathy being an inflammatory disease, we measured the effects of a new hetrazepine platelet activating factor antagonist, BN 50730, on a vincristine‐induced retinopathy in the rat. Retinal impairments were established by recording several parameters of the electroretinogram obtained from isolated retina. Our results indicate that 1) the increase in PIII duration induced by vincristine is significantly reduced by BN 50730 administration 2) the decrease in the amplitude of the PIII/b wave ratio caused by vincristine is partially inhibited by treatment with BN 50730. These experiments suggest that platelet activating factor is implicated in vincristine retinopathy and demonstrate the therapeutic effect of a specific antagonist of the mediator.
Effect of hyperglycemia duration on rabbit corneal thickness and endothelial ATPase activity
Authors: Herse Peter , Adams Linda
Published: May 2009

ABSTRACT This study compares corneal thickness and corneal endothelial Na,K ATPase activity in normal and age‐matched diabetic rabbits with up to 10 weeks of hyperglycemia. Corneal endothelial Na,K ATPase activity in normal rabbits increased between 10 and 20 weeks of age. Corneal thickness increased after 5 weeks of hyperglycemia. Decreased corneal endothelial homogenate Na,K ATPase activity was first seen after 10 weeks of hyperglycemia, though an earlier onset was possible due to sampling restrictions. Corneal endothelial homogenate Mg ++ ATPase activity showed a transient increase after 2 to 5 weeks of hyperglycemia. This study shows that hyperglycemia in rabbit is associated with complex dynamic interactions between corneal thickness and corneal endothelial Mg ++ ATPase and Na,K ATPase activities.
Increased IgA antibodies to gluten and gliadin in serum of persons with ocular pseudo‐exfoliation
Authors: Ringvold Amund , Øvergaard Ralf G.
Published: May 2009

ABSTRACT Three of 12 persons with pseudo‐exfoliation syndrome revealed increased IgA serum antibodies to gluten and gliadin vs none in the control group. The phenomenon is suggested to indicate barrier breakdown in the gut wall.
Clinical comparison of the XPERTTMnon‐contact tonometer and the conventional Goldmann applanation tonometer
Authors: Hansen Mette Kaas
Published: May 2009

ABSTRACTIntraocular pressure (IOP) in the right eye of 113 patients was measured with one XPERTTMNCTTMair‐puff non‐contact tonometer (XPERT) and compared with IOP measured with one Goldmann applanation tonometer (GAT). Precision of the methods was judged by variance analysis, indicating that GAT was slightly more precise than XPERT. The slope of the linear relationship between the methods did not differ significantly from 1.0. Mean difference between the methods was 0.92 mmHg, XPERT measuring lower than GAT, p = 0.00017. The intra‐individual difference between methods ranged from ‐8.00 to 8.67 mmHg, and standard deviation (SD) of differences was 2.52 mmHg. The 95% limits of agreement between the two methods were ‐5.85 to 4.01 mmHg. The SD of differences is of approximately the same size as previous XPERT vs GAT as well as previous GAT vs GAT studies.
Successful outcome of preoperative prism adaptation for decompensated microtropia in an adult
Authors: Leach Carolyn M. , Burke John P.
Published: May 2009

ABSTRACT A 27‐year‐old myopic female presented with a recurrence of constant horizontal diplopia secondary to a decompensated microtropia. Following prism adaptation the patient underwent strabismus surgery for the prism adapted angle. A successful outcome ensued; the patient's alignment remains stable and she continues to be symptom free 12 months postoperatively.
Argon and low energy, pulsed Nd:YAG laser trabeculoplasty
Authors: Holló Gábor
Published: May 2009

ABSTRACT Argon laser trabeculoplasty (ALT; 1.0 W, 0.1 sec, 50 μm) was performed in right eyes, and low energy, Q‐switched Nd:YAG laser trabeculoplasty (Nd:YAGLT; 1.1–4.8 mJ/pulse) in left eyes of 14 patients with primary open‐angle glaucoma and in one patient with juvenile glaucoma. The pre‐laser intraocular pressure (IOP) was medically uncontrollable (IOP > 21 mmHg). The interocular pressure difference varied between 0 and 3 mmHg. In 9 patients IOP decreased to less than 22 mmHg (success) in both eyes. No statistically significant difference has been revealed with paired t‐test in the degree of IOP decrease between ALT and Nd:YAGLT treated eyes during the 1–18 months' follow‐up. Treatment variables of Nd:YAGLT had no statistically significant effect on the duration of the post‐laser success with Cox‐regression. In 4 patients both treatments were ineffective (IOP > 21 mmHg). In 2 patients ALT was successful but Nd:YAGLT was ineffective. In three cases of early bilateral laser failure (IOP > 21 mmHg at the first month visit) trabeculectomy was performed on both eyes in the third post‐laser month. Following ALT the uveoscleral meshwork was severely destroyed in the area of the laser spots, and the surrounding collagen fibres were heat‐damaged. The meshwork between the laser spots was covered by a membrane formed by migrating endothelial cells. In the uveoscleral meshwork Nd:YAGLT induced severe focal damage surrounded by circumscript shrinkage and scarring. The juxtacanalicular tissue remained free of laser induced damage. No endothelial membrane was present. The results suggest that low energy, Q‐switched Nd:YAGLT may represent an alternative method of glaucoma laser surgery.
Prognostic factors in long‐term intraocular pressure control following combined phacoemulsification and trabeculectomy
Authors: Stewart William C. , Crinkley Crystal M.C. , Carlson Alan N.
Published: May 2009

ABSTRACT We studied 36 consecutive patients who underwent combined phacoemulsification and trabeculectomy to determine prognostic factors associated with intraocular pressure control one year postoperatively. In patients who were either easier (intraocular pressure < 16 mmHg, n = 19) or more difficult (≥ 16 mmHg, n = 17) to control, the mean intraocular pressure increased up to the fourth week postoperatively. In the more difficult to control group, however, the intraocular pressure continued to increase and a statistical difference between groups was noted by the second month postoperatively (P < 0.05). The peak intraocular pressure within the first month postoperatively was lower in patients easier to control long‐term (P < 0.005). No statistical difference between groups in the filtering bleb or anterior chamber appearance, or postoperative complications, was noted (P > 0.05). This study suggests combined trabeculectomy and phacoemulsification is safe and effective in controlling intraocular pressure postoperatively. Determining from the early postoperative examination the long‐term pressure control, however, is difficult.
Effect of topical apraclonidine on flow properties of central retinal and ophthalmic arteries
Authors: Çeliker Ülkü Ö. , Çelebi Serdal , Çeliker Hüseyin , Çelebi Harika
Published: May 2009

ABSTRACT To investigate the acute effects of topically administered 1% apraclonidine hydrochloride on blood velocity and resistance parameters of central retinal and ophthalmic arteries, the vessels were studied by color Doppler ultrasonography during baseline and at the time of peak effect of apraclonidine in 20 healthy volunteers. After medication, significant decrease in peak systolic, peak diastolic, mean flow velocities and increase in resistive and pulsatility indices of ophthalmic artery were observed. Blood velocity and resistance parameters of central retinal artery didn't change significantly. In conclusion, topically used apraclonidine was thought to change the blood velocity and resistance parameters of ophthalmic artery as a result of its local vasoconstrictory effect on the anterior segment branches of ophthalmic artery.