bluuebunny/crossref_metadata_2025 huggingface dataset:
ICAM‐1 and HLADR expression on conjunctival epithelial cells in patients with Graves’ orbitopathy and Graves’ disease ‐ preliminary report
Authors: PAWLOWSKI P , MYSLIWIEC J , MRUGACZ M , BAKUNOWICZ‐LAZARCZYK A , ZAK J , WYSOCKA J , GORSKA M
Published: December 2011

Purpose The objective of the study was to evaluate wheather an assessment of conjunctival epithelium expression of HLA‐DR and ICAM‐1 could be helpful as an early marker of local inflamation in the eye and the orbital tissue.

Methods Specimens for flow‐cytometric evaluations of ICAM‐I and HLADR expression were collected by impression of ocular surface from 8 eyes with Graves’ diaseas without signs of active Graves’ orbitopathy (CAS ≤ 4), from 8 eyes of patients with active Graves’ orbitopathy (CAS ≥ 4) and from 14 normal speciments without any ocular surface disorders.

Results Decreased fluorescence of ICAM‐1 on conjunctival epithelium cells was detected in patients with active Graves orbitopathy vs. patients with Graves wihout orbitopathy. There was no correlation between the CAS and NOSPECS values and the expression of ICAM‐I and HLADR expression on conjuctival epithelium.

Conclusion Results of this preliminary study confirm that conjunctival epithelial cells may abnormally express ICAM‐1 on conjunctival epithelium cells in active ocular surface disorder like Graves orbitopathy. Nethertheless, since the number of the examined patients needs to be enlarged the study needs further examination.
Small aperture keratophakia for correction of presbyopia
Authors: RIHA W , GRABNER G
Published: December 2011

Purpose To assess the safety and efficacy of a small‐aperture optic device for the treatment of presbyopia in emmetropic presbyopes.

Methods The Kamra Inlay, formerly known as the AcuFocus ACI corneal inlay (AcuFocus, Irvine, CA), is an ultrathin microperforated, opaque artificial aperture (3.8 mm outer diameter and 1.6 mm inner diameter) made of highly biocompatible polyvinylidene flouride (PVDF). A randomized pattern of minute holes allows nutritional flow through the implant to the anterior stroma. Following creation of a superior‐hinged flap in the non‐dominant eye, a Kamra inlay was centered on the stroma based on the first Purkinje reflex in 32 emmetropic patients with a mean age of 51.20 ± 2.2 years. Manifest refraction and visual acuity at three years postoperative are reported here. Four year data will be presented at the meeting.

Results In the implanted eye, mean spherical equivalent shifted from 0.19 ± 0.22 D preop to 0.08 ± 0.68D at 3 years. Mean UNVA improved from J7/J8 to J1 at 3 years. Mean UIVA went from 20/40 preop to 20/25 at 3 years. Mean UDVA decreased slightly from 20/16 to 20/20 at 3 years. At 3 years, all eyes achieved UDVA of 20/32 or better. Mean binocular UDVA was 20/16. There were no explants. Two inlays had to be recentered due to initial misplacement. During the follow up period, no irritation, inflammatory reactions, or changes in corneal appearance were observed.

Conclusion The Kamra corneal inlay improves near and intermediate vision without severe loss of distance visual acuity in emmetropic presbyopes by increasing the depth of field, based on the small aperture optics concept.

Commercial interest
Histopathology of Behçet’s uveitis
Authors: DAMATO EM , DICK A , COUPLAND SE
Published: December 2011

Purpose To report the histological findings in an eye with severe Behçet’s disease.

Methods A 17‐year‐old male had a longstanding history of chronic intraocular inflammation, which was treated with high dose steroids, immunosuppression and biological agents (anti‐TNF therapy). Despite this aggressive treatment, he suffered persistent uveitis, and had also undergone cataract and pars plana vitrectomy with silicone oil tamponade. Eventually the patient underwent enucleation of his left eye, which had become blind and painful. The specimen was sent to the Pathology Dept. RLBUHT, for morphological examination.

Results Histological sections of the enucleated eye demonstrated extensive pathological changes. These included: chronic keratitis with associated neovascularisation; severe chronic granulomatous iridocyclitis with the development of anterior synechiae with angle closure, as well as extensive posterior cyclitic membrane formation with ciliary process destruction. The inflammation, which was characterised by dense lymphocytic and plasma cell infiltrates, extended posteriorly into the choroid, focally involving the retina. Chronic vasculitis resulted in a typical “onion‐skinning” appearance of some blood vessels. There was optic disc cupping. Immunohistochemistry was performed to characterise the lymphocytic and plasma cell populations.

Conclusion This case is a rare example of end‐stage Behçet’s disease in which the histopathological alterations will be demonstrated.
Vitreo‐retinal interactions and optical coherence tomography study in Fuchs’ uveitis
Authors: BOUCHENAKI N , HERBORT C
Published: December 2011

Purpose To evaluate an describe vitreo‐retinal interactions by Optical Coherence Tomography (OCT) in Fuchs’ uveitis.

Methods Retrospective study including 29 patients (31 eyes) with Fuchs’ uveitis who underwent OCT evaluation. Vitreo‐retinal interface was analyzed and morphological changes described and compared to the normal controlateral eye (except 2 bilateral cases).

Results Vitreo‐retinal modifications were seen on OCT in 90% of Fuchs’ uveitis patients. The main vitreo‐retinal interactions that could be described were : retinal surface fibrosis (43.3%), epiretinal membrane (33.3%), vitreo‐retinal traction (23.3%), foveal vitreous opacity (23.3%).

Conclusion Vitreous involvement is a characteristic feature of Fuchs’ uveitis with cellular infiltration and/or vitreous opacification, moreover, these OCT findings show that there is a high prevalence of vitreoretinal abnormalities in Fuchs’ uveitis.
The effect of cataract surgery on imaging optic nerve head topography with the Heidelberg Retina Tomograph
Authors: FALCK AAK , SAARELA V
Published: December 2011

Purpose The purpose of this study was to determine whether phacoemulsification cataract surgery with intraocular lens (IOL) implantation has an effect on measuring optic nerve head (ONH) topography using the Heidelberg Retina Tomograph (HRT).

Methods The study population inculuded 31 women and 12 men aged 59‐81 years with no previous history of eye diseases, surgery, laser procedures or medication. The patients underwent first‐eye cataract surgery for senile cataract. HRT II with software version 1.6 was used to obtain three‐dimensional images of the ONH as a part of a meticulous eye examination. The quality of the HRT image was assessed using topography standard deviation (TSD). The topography measurements are considered unreliable if TSD is more than 50 µm. Re‐examination took place one month after surgery.

Results Before surgery the topography measurements were unreliable in 33% (14/43) of the eyes; in 4 of these cases ONH topography could not be calculated at all. One month after cataract surgery the ONH topography could be calculated in all eyes and only one had unreliable topography measurements. The mean TSD was 39 µm before and 22 µm after surgery when calculated for all eyes with measurable topographies. The change in the TSD was statistically significant (p<0.0005). The image alignment between the HRT examinations before and after surgery was excellent in 67% (26/39). Magnification changes occurred in 13% (5/39) of the eyes.

Conclusion Phacoemulsification cataract surgery with IOL implantation improves the image quality of the HRT. Because of magnification changes and image misalignment, HRT follow‐up over cataract surgery was unreliable in more than one third of eyes.
Optic disc assessment using confocal scanning laser ophthalmoscope in normal tension glaucoma with disc hemorrhage
Authors: LIM S
Published: December 2011

Purpose To evaluate which optic disc parameters have a relationship with the presence and the location of disc hemorrhages in normal tension glaucoma (NTG)

Methods This retrospective study included patients with early NTG with mean deviation with – 10 dB or better in 24‐2 Humphrey visual field analyzer. Eyes in the whole study group were divided into those with and without disc hemorrhage. Optic disc stereometric parameters measured using the Heidelberg Retina Tomograph (HRT) III were compared between each group with and without disc hemorrhage. Within the group with disc hemorrhage, the location of disc hemorrhage was analyzed. Sectoral disc parameters were compared between two common locations where disc hemorrhage developed.

Results Forty‐three patients with disc hemorrhage and 46 patients without disc hemorrhage were included in this study. Mean deviation and pattern standard deviation showed no significant difference between two groups. There was no significant difference in global optic disc parameters of HRT between two groups. Disc hemorrhage was displayed mainly in inferotemporal (23 eyes, 53.5%) and in superotemporal (12 eyes, 27.9 %). Regarding to sectoral disc analysis of inferotemporal quadrant, the value of cup shape measure and cup disc area ratio was higher in the disc hemorrhage group compared to the group without disc hemorrhage (P=0.0013, P=0.013, repectively). The subset analysis of disc parameters within the disc hemorrhage group, showed that superotemporal maximum cup depth in eyes with superotemporal disc hemorrhage was greater compared to inferotemporal maximum cup depth in eyes with inferotemporal disc hemorrhage (P=0.017).

Conclusion The change of optic disc parameters in early NTG patients with disc hemorrha

Commercial interest
GDx‐VCC vs GDx‐ECC in glaucoma diagnosis
Authors: MILANO G , LOMBARDO S , BORDIN M , BOSSOLESI L , RAIMONDI M , LANTERI S , ROSSI GCM
Published: December 2011

Purpose To compare results provided by scanning laser polarimetry variable corneal compensation (VCC) vs enhanced corneal compensation (ECC) and evaluate correlation to visual field results in glaucoma patients.

Methods Study included 339 eyes of 182 patients screened by the glaucoma unit of the University Eye Clinic of Pavia (Italy). Patients were submitted to complete ophthalmic examination, standard automated perimetry (SAP), scanning laser polarimetry with GDx‐VCC and GDx‐ECC. Quality image (Q), typical scan score (TSS), nerve fibers index (NFI), nerve fibers layer average thickness in a band around the optic nerve head (TSNIT average) and in the upper (TSNIT sup) and lower sector (TSNIT inf) were evaluated for each exam. Q, TSS and morphometric parameters provided by VCC and ECC were compared using Wilcoxon signed‐rank test and Lin correlation coefficient. Correlation between GDx and perimetric global indexes and was evaluated with Pearson correlation index “r”.

Results 204 images out of 339 (60%) were of good quality (Q>7) with VCC and 325 out of 339 (96%) with ECC. 140 images out of 339 (41%) were atypical (TSS<80) with VCC but only 20 out of 339 with ECC (6%). ECC vs VCC constantly displays lower TSNIT thickness and higher NFI. All comparisons between ECC and VCC parameters showed statistically significant differences confirmed by a moderate to poor concordance between the two instruments. Structure/function correlation was better for ECC parameters and first of all for NFI.

Conclusion ECC provides better quality images than VCC. High quality exam is the first condition to reproduce a more reliable RNFL structure. ECC points out lower RNFL thickness and higher NFI and reveal a better correlation to perimetric indexes MD and PSD as compared to VCC. GDx‐ECC could improve early glaucoma diagnosis.
Quality of life after treatment of uveal melanoma
Authors: DAMATO BE , HOPE‐STONE L , SALMON P
Published: December 2011

Purpose Uveal melanoma threatens the patient with metastatic death, visual handicap, loss of independence, financial hardship, and facial disfigurement. Ocular treatment is aimed not only at preventing metastatic death but also enhancing the patient's quality of life by conserving the eye and useful vision. The aim of this study was to measure quality of life after treatment of uveal melanoma and to correlate psychological well‐being with age, sex, prognosis, ocular outcomes, family support and other factors.

Methods We measured functional well‐being, anxiety and depression in 511 patients treated for uveal melanoma in the previous five years and, using hierarchical linear regression analysis, we correlated the results with sociodemographic characteristics, baseline ocular features, tumour stage, ocular treatment, and post‐treatment ocular symptoms.

Results Levels of function, depression and anxiety were similar to normative values. All outcomes were unrelated to visual acuity, tumour characteristics, whether or not the eye was preserved and the time since being treated. Women were more anxious than men, and older patients were more depressed than younger ones. Patients with good social support had consistently better outcomes than those with poor support.Patients with local recurrence at the time of completing questionnaires tended to be more anxious than others, but were not more impaired in depression or function. All PROMS were associated with ophthalmological symptoms. Patients with worse symptoms had poorer function and worse depression and anxiety.

Conclusion Patients can be reassured that good psychological outcomes are normal, especially if there is good social support.
CNS abnormalities in retinoblastoma patients
Authors: HADJISTILIANOU D , DE FRANCESCO S , RENIERI A , MENCARELLI MA , MAROZZA A , DE LUCA M , MICHELI L , MENICACCI C , CERASE A , GALLUZZI P
Published: December 2011

Purpose The presence of CNS abnormalities on MR images in a large group of consecutive patients with retinoblastoma (RTB) is evaluated. Mental retardation and congenital brain anomalies are reported in patients with RTB, mostly in combination with 13q deletion syndrome. Pineoblastoma (PNB) is the most important and “life threatening” condition associated with hereditary RTB, but recent studies suggest an association with pineal cysts. This association is important because some PNB mimic pineal cysts

Methods CNS MR images of 320 consecutive patients with RTB from 2000 to 2010 were evaluated by neuroradiologists for tumors, structural anomalies, myelinization, and coincidental findings. Clinical records were reviewed for laterality, heredity, and the presence of the 13q deletion syndrome.

Results The hereditary group (patients with bilateral and unilateral proved RB1‐germline mutation) included 42 (48.2%) of 87 patients. Nine patients had 13q deletion syndrome. Normal findings on brain MR images were seen in 305 (95.3%) patients. One PNB was detected in a patient with hereditary RTB and 2 arachnoid cysts in 2 sporadic unilateral RTB patients; one cerebral and corpus callosum atrophy and 3 pineal cysts were also detected (2 non hereditary, 1 in 13q deletion syndrome). Corpus callosum agenesis was found in 3 patients (two in 13q deletion syndrome, 1 in hereditary RTB) and corpus callosum hypoplasia in 6 patients (2 twins, 4 sporadic RTB, 1 familial RTB). Chiari I syndrome was found in two cases

Conclusion PNB is associated with hereditary RTB, and structural brain abnormalities are associated not only with 13q deletion syndrome. Pineal cysts can be detected in patients with sporadic RTB and/or with 13q deletion syndrome.
Propranolol in the management of orbital and periocular pediatric hemangioma
Authors: MIDENA E , PARROZZANI R , DARIO A , MIGLIONICO G , BISOGNO G , FLORA GP
Published: December 2011

Purpose To discuss the use of propranolol (and other β‐blockers) in the treatment of pediatric orbital and periocular capillary hemangiomas, and perform literature review.

Methods Two babies (3 and 5 months) affected by orbital capillary haemangioma with cutaneous periocular involvement were treated by oral propranolol (2 mg/kg/day) as a sole treatment. Complete baseline local and systemic examination revealed no contraindication to treatment. A strict follow‐up protocol was performed to monitor tumor changes and any side effect. Follow‐up was longer than 12 months.

Results Both patients had significant improvement with resolution of the orbital component and slower resolution of the cutaneous side. No local or general (mainly hypotension, hypoglycaemia and asthma) side effects of propranolol were observed.

Conclusion Propranolol appears to be a safe and effective option in the management of infantile capillary haemangioma. The role of other β‐blockers, even topically applied, should be considered.
Puzzling case of choroidal tumor: paraganglioma or neuroendocrine carcinoma, diagnosis and treatment options
Authors: VAN GINDERDEUREN R , MISSOTTEN G , VAN DEN OORD J
Published: December 2011

Purpose A monophthalmic patient was referred with different choroidal tumors in his only left eye, for advise about the diagnosis and different treatment options.

Methods In 2006 the right eye was enucleated for melanoma. In 2009 a skin melanoma on the head was resected, and in 2010 a neuroendocrine adenocarcinoma (NEAC) of the prostate was diagnosed with a liver metastasis of NEAC. Multiple metastatic lesions were detected by ct on liver, spine and abdomen without any complains. The different treatment options and correlations between these 4 tumors were investigated

Results After review of the 4 biopsies the final diagnosis was: 2 different tumors: a paraganglioma in the left eye with skin metastasis and NEAD in the prostate with hepatic metastasis. The tumors in the left eye are presumed to be metastases of one of the originals or a new location of one. Both type of tumors have common clinical and pathologic characteristics and a genetic predisposition is suggested. In most cases there is a favorable prognosis. The vision of the left eye was 7/10 with diffuse metamorphopsia, because of subretinal fluid around the tumors. The treatment options were discussed and external beam radiation to the left eye was performed to stabilize the tumors. He was in general good health, although multiple detected metastases on imaging

Conclusion This case shows a very rare paraganglioma in one eye in a patient with multiple NEAD and metastates in the other eye; this demonstrates the possible genetic link between both rare entities
S100 expression in normal and pathological sclerocorneal limbus
Authors: CALIENNO R , CURCIO C , LANZINI M , NUBILE M , COLASANTE M , MASTROPASQUA L
Published: December 2011

Purpose Several molecules have been proposed as corneal epithelial stem cell (SC) markers but none of them is able to identify SC in normal or pathological conditions.S100 proteins make up the largest subfamily of the EFhand Ca+binding protein family. The function of S100 is unknown but its expression was already known in pterigium and corneal epithelium in keratoconus.The aim of this study was to evaluate expression of S100 proteins as an early marker of SC deficiency.

Methods The expression of S100 proteins was evaluated in four healthy sclerocorneal limbus and in five cases of pathological limbus due to severe inflammation: a case of corneal melting and perforation in advanced herpes simplex (HSV) disease, three cases of endophthalmitis and a case of fungal infection were analyzed. All samples were fixed in formalin,embedded in paraffin and stained by immunohistochemistry

Results In normal limbus, S100 proteins were positive and in particular we observed no difference between different dimension crypts. No expression of S100 was detected in almost all pathological cases.

Conclusion This result suggest that S100 proteins can be useful as marker of early pathological changes in SC niches.
CREB is involved in growth of pterygia
Authors: CURCIO C , CALIENNO R , LANZINI M , NUBILE M , MASTROPASQUA L
Published: December 2011

Purpose Pterygium represent a fibrovascular lesion of ocular surface with tumor‐like characteristics, such as proliferation and infiltration. Although the exact pathogenesis of pterygium is unknown, and controversy exists about cells origin and nature of initial tigger required for its development. In this study we investigated the role of the transcription factor cAMP response‐element binding protein (CREB) in pterygial and normal conjunctival tissues of humans.

Methods Samples of primary (n=14) and recurrent (n=4) pterygia and normal bulbar conjunctivas (n=3), surgical removed, were analyzed in this study. Formalin‐fixed, paraffin embedded tissues were used for immunohistochemical staining with CREB, vimentin, ki67, survivin, MMP7, p63, cycin D1 or p53 antibody.

Results Immunoreactivity for CREB was detected in primary and recurrent pterygia. CREB positivity was localized in the epithelial compartment of pterygia and it was absent in the stroma and normal conjunctiva. We observed a good correlation between CREB and other markers commonly overexpressed in pterygia (in particular vimentin, survivin and MMP7). An interesting aspect is the localization of CREB and ki67 positive cells, suggesting that the noxa pathogena have an effect on epithelial cells that express CREB and induce epithelial proliferation factors, followed by stromal growth.

Conclusion These preliminary results point to the epithelial origin of pterygia. They also throw fresh light on CREB function and may be of assistance in the elaboration of new approaches to the treatment of pterygium.
Epiretinal membranes in a patient with Scheie's syndrome diagnosed using a high‐resolution SD‐OCT
Authors: STRATOS A , PATSEA E , XALKIADAKIS I , PARIKAKIS EA , STERGIOPOULOS G , PEPONIS V , MITROPOULOS P
Published: December 2011

Purpose To report a case of a young woman with Mucopolysaccharidosis I‐S (Scheie's Syndrome) having bilateral epiretinal membranes (ERMs) which have been confirmed by the use of a high resolution spectral‐domain optical coherence tomography (Spectralis SD‐OCT).

Methods A 28 year‐old female, diagnosed with Scheie's Syndrome since 8 years old, was examined in our department. For the last 6 years she has been receiving weekly intravenous laronidase. In manifest refraction the patient achieved a visual acuity of 20/40 OD and 20/32 OS with a high hyperopic spherical equivalent correction (+7.50D, OU). Slit‐lamp anterior segment examination showed the presence of diffuse corneal haze in both eyes which obscured retinal view. During dilated fundus examination she complained of severe photophobia. An OCT examination using the Spectralis SD‐OCT (Heidelberg Engineering, Germany) was performed to evaluate the retinal pathology.

Results The SD‐OCT examination revealed the presence of epiretinal membranes in both eyes without any signs of macular edema.

Conclusion In patients with mucopolysacharidosis I the view of retinal abnormalities with the use of a slit‐lamp biomicroscope could be difficult due to corneal haze and severe photophobia. SD‐OCT examination is an alternative method to investigate the presence of epiretinal membranes or other retinal pathology in such cases.
Orbital involvement in multiple myeloma
Authors: FERNANDEZ‐PEREZ S , SATUE M , HERRERO LATORRE R , DE LA MATA G , IDOIPE M , GARCIA‐MARTIN E , PABLO L
Published: December 2011

Purpose To present the case report of a patient with multiple myeloma who develops orbital infiltration in the left side due to the myeloma.

Methods A 53‐year‐old male with the diagnosis of IgA‐kappa multiple myeloma 3 years ago, stage III B in the staging system of Durie and Salmon, who has increased the volume in the left upper eyelid region in recent months. On examination the patient had moderate ptosis without affecting the pupillary axis, exophthalmos of 22.5 mm, hypotropia in primary position of gaze and limitation of supraversion left eye. Radiological and histological findings confirmed the existence of orbital extension of multiple myeloma at the supero‐internal quadrant.

Results The patient has received several lines of chemotherapy treatment and autologous bone marrow transplantation without systemic or orbital improvement. Because of its systemic poor condition has been rejected surgical treatment and radiotherapy to the orbital level.

Conclusion Although orbital involvement is rare and there are few reports in the literature, a patient with multiple myeloma who presents proptosis and / or increased the orbital volume, we must consider orbital infiltration by myeloma however, definitive diagnosis is histological.
Atypical inflammatory myofibroblastic pseudotumor of the etmoidal sinus extending into the orbit
Authors: DE KEIZER RJW , LAUWERS N , DE GROOT V , CLAES J
Published: December 2011

Purpose To report a case of an atypical inflammatory pseudotumor of the paranasal sinuses with bony invasion extending into the orbit .

Methods Case‐report.

Results A 71‐year old man presented with slowly progressive painless diplopia followed by unilateral proptosis of the left eye with a slight edema of the upper eyelid. Visual acuity was 0.4 with a relative afferent pupillary defect . Abduction and depression of the left eye were limited. Imaging showed an orbital tumor around the obliquus superior with lateral displacement, possible infiltration of the superior and medial rectus, involvement of fossa pterygopalatinum , sinus etmoidalis, sphenoidalis and maxillaris , intracranial extension through the fissura orbitalis superior, bone erosion and sclerotic bone reaction. Endoscopic ethmoïdal, maxillary and orbital biopsies discovered a inflammatory myofibroblastic tumor. Blood parameters showed eosinophily. ANCA and CRP were negative. Discussion: In the literature three cases of orbital myofibroblastic tumors have been described but never with bone invasion. Only a few sinus inflammatory pseudotumors with bony erosion have been reported. Central nervous system myofibroblastic tumors give a dura based mass‐formingan en plaque pattern. Two cases with orbital involvement have been described.

Conclusion : This eroding sino‐orbital inflammatory myofibroblastic tumor is a new finding mimicking a malignant tumor.
Optic disc coloboma in the mouse
Authors: JACKSON I
Published: December 2011

Abstract not provided
Optic nerve head blood flow response to increase of arterial blood pressure in humans
Authors: LACHARME T , GEISER M , ALMANJOUMI A , KHAYI H , ARNOL N , ROMANET JP , CHIQUET C
Published: December 2011

Purpose Autoregulation in ocular tissues allows a constant blood flow despite variations in ocular perfusion pressure and may be impaired in ocular diseases. The purpose of this study was to investigate the effect of increased blood pressure (BP) and ocular perfusion pressure (OPP) during isometric exercise on the optic nerve head blood flow (FONH).

Methods In 21 healthy subjects, aged 18 to 40 years, BP was measured using a pneumatic transcutaneous sensor Nexfin™ and blood flow was measured using LDF. OPP was defined as (0.74 × mean BP) – intraocular pressure. Handgripping consisted of static contraction of the finger flexors at 30% of maximum contraction force using a hand dynamometer during two minutes.

Results Data was analyzed in 15 healthy subjects, exhibiting a homogeneous response of BP to handgrip (linear regression of BP versus time, R> 0.8). A large increase in OPP during exercise up to 50% was not associated with a proportional increase in FONH, vascular resistance increased about 30%. The blood flow‐pressure relationship showed blood flow significantly increased by approximately 30%, mainly due to the rise of velocity.

Conclusion This new data strongly supports the notion of autoregulation in ocular blood flow, protecting the eye from over‐perfusion. However the increase in OPP is not completely counterbalance despite the regular increase of vascular resistance. This blood flow regulation is possibly due to a vasoconstriction, taking place outside of the sampled volume, probably in the arterioles proximal to the capillary bed of the neuroretinal rim. In the future, real time measurements of vascular resistance during handgripping could be investigated in glaucoma patients.
Asymmetric color perception in the shopping aisle: some implications for merchandising
Authors: PINNA A , PUGLIATTI M , PORCHEDDU D
Published: December 2011

Purpose To investigate the perception of colored items in the aisle of a virtual store and establish whether it may be affected by their position on shelves.

Methods 50 apparently healthy, right‐handed university students, recruited on a voluntary basis, were included in this study. Inclusion criteria included: 1) visual acuity ≥ 20/20 in each eye; 2) normal color vision; 3) right‐handedness, assessed by the Edinburgh inventory; 4) no history of ophthalmic and/or neurological disorders. Each subject was asked to look at 3 series of 18 images each on a plasma screen; the images showed a virtual modern store aisle, as it would be seen by a customer standing at one end in a central position and looking straight ahead. On both sides, the virtual aisle had 5 shelves, each containing 39 items of the same size and shape. In each image, apart from one single colored item, all other items were gray. In each series, the colored item was always of the same color, namely blue, red or green. All colors were monochromatic and had the same level of saturation. To avoid perceptive bias, all the images shown were perfectly symmetrical to the vertical axis. For each image, subjects were asked to locate as quickly as possible the colored item. Correctness and response time of answers were recorded. Statistical analysis was performed by ANOVA.

Results Statistical analysis showed that the coloured items were perceived significantly more accurately and rapidly when they were located on the left.

Conclusion Results support the idea of an asymmetric perception of colored items in the shopping aisle, suggesting that item location on store shelves may have important implications for merchandising.
Innovative thiomer technology ‐ application to dry eye syndrome
Authors: SCHMETTERER L
Published: December 2011

Purpose Pre‐clinical and clinical studies were performed to study the safety and efficacy of a novel thiolated biopolymer, namely chitosan‐N‐acetylcysteine,. The mechanism of action is based on the interaction between thiol groups of the topically applied chitosan‐N‐acetylcysteine and cysteine‐rich mucin (MUC5AC). The hypothesis that this increases polymer residence time on the ocular surface and provides tear film stability was tested.

Methods The efficacy of isotonic and buffered chitosan‐N‐acetylcysteine eye drops was studied in two different mouse models of dry eye disease. The dosage dependent ocular residence time and biodistribution were investigated in a rabbit model using microPET technology. Long‐term irritation and delayed‐type hypersensitivity tests with chitosan‐N‐acteylcysteine eye drop formulation were conducted in rabbits. Three phase one studies in healthy volunteers were performed to find an optimal dose and to test the safety of the formulation in humans.

Results In mice treated with chitosan‐N‐acetylcysteine decreased expression of ocular surface mRNA of IL‐β, IL‐10, IL‐12α, and TNF was observed, indicating that the formulation decreases surface inflammation in models of dry eye. The residence time of chitosan‐N‐acetylcysteine eye drops on the ocular surface of rabbits was as high as 22h. Results of a long‐term ocular irritation study in rabbits demonstrate that chitosan‐N‐acetylcysteine was well tolerated and non‐irritant to the eye. In the phase I studies in healthy humans, safety and tolerability was demonstrated.

Conclusion Safety and efficacy of chitosan‐N‐acetylcysteine was shown in different animal models. The long residence time of the polymer at the ocular surface makes it an attractive treatment approach for dry eye disease. Since the phase one studies showed a favourable safety profile in healthy subjects a phase two trial is planned in the near future.
Photoautotrophic–heterotrophic biofilm communities: a laboratory incubator designed for growing axenic diatoms and bacteria in defined mixed‐species biofilms
Authors: Buhmann Matthias , Kroth Peter G. , Schleheck David
Published: December 2011

Biofilm communities in the euphotic zone of aquatic habitats comprise photoautotrophic microorganisms, such as diatoms, green algae and cyanobacteria, which produce the organic carbon that fuels the life of a heterotrophic contingent of microorganisms, mostly bacteria. Such photoautotrophic–heterotrophic mixed‐species biofilms have received little attention in biofilm research due to a lack of suitable pure‐culture laboratory model systems. However, they offer important insight into microbial population dynamics and community interactions during a biofilm‐developmental process that shapes highly structured, extremely well‐adapted microbial landscapes. Here, we report on the development of a sterile incubation chamber for growing and monitoring axenic phototrophic biofilms, i.e. a sterilizable, illuminated, continuous‐flow system for a routine work with pure cultures. The system has been designed to simulate the growth conditions in the shallow, littoral zone of aquatic habitats (horizontal surface, submerged in water, illuminated, aerated). Additional features of the concept include automated photometrical monitoring of biofilm density (as biofilm turbidity), analysis via confocal microscopy, direct harvesting of cells, and options to control illumination, flow velocity, and composition of culture fluid. The application of the system was demonstrated in growth experiments using axenic diatom biofilms, or axenic diatom biofilms co‐cultivated with different bacterial strains isolated from epilithic biofilms of an oligotrophic freshwater lake.
A Knowledge-based Diagnostic Clinical Decision Support System for Musculoskeletal Disorders of the Shoulder for Use in a Primary Care Setting
Authors: Farmer Nicholas , Schilstra Maria J.
Published: December 2011

Background

Twenty percent of cases seen by primary care clinicians (general practitioners; GPs) are musculoskeletal in nature, and approximately one-quarter of these are shoulder complaints. GPs are increasingly overloaded with clinical information and unfamiliarity with current research can easily lead to misdiagnosis and, in turn, to unnecessary test requests or onward specialist referrals. Well-designed diagnostic clinical decision support systems (CDSS) have been shown to facilitate clinical decision-making and reduce diagnostic errors. However, no CDSS have been developed or tested for musculoskeletal disorders.

Methods

We have developed a prototype knowledge-based diagnostic CDSS for musculoskeletal shoulder conditions. The CDSS uses Bayesian reasoning to diagnose six common musculoskeletal shoulder pathologies, based on current evidence and expert opinion. The CDSS was tested by comparing its diagnostic outcome against 50 case studies with known diagnosis by radiological imaging.

Results

The CDSS diagnostic validity and reliability was shown to be 88% with a Kappa value of 0.85 to a confidence level of 99% compared to known diagnosis by radiological imaging.

Conclusions

The results suggest that a Bayesian network-based CDSS is a promising instrument in the diagnosis of musculoskeletal shoulder conditions, having been shown to be valid and reliable for 50 case studies.
Cathepsin K Expression and Activity in Canine Osteosarcoma
Authors: Schmit J.M. , Pondenis H.C. , Barger A.M. , Borst L.B. , Garrett L.D. , Wypij J.M. , Neumann Z.L. , Fan T.M.
Published: December 2011

Background

Cathepsin K (CatK) is a lysosomal protease with collagenolytic activity, and its secretion by osteoclasts is responsible for degrading organic bone matrix. People with pathologic bone resorption have higher circulating CatK concentrations.

Hypothesis

Canine osteosarcoma (OS) cells will possess CatK, and its secretion will be cytokine inducible. Circulating CatK concentrations will be increased in dogs with OS, and will be a surrogate marker of bone resorption.

Animals

Fifty‐one dogs with appendicular OS and 18 age‐ and weight‐matched healthy control dogs.

Methods

In a prospective study, expressions of CatK mRNA and protein were investigated in OS cells. The inducible secretion and proteolytic activity of CatK from OS cells was assessed in vitro. Serum CatK concentrations were quantified in normal dogs and dogs with OS and its utility as a bone resorption marker was evaluated in dogs with OS treated with palliative radiation and antiresorptive agents.

Results

Canine OS cells contain preformed CatK within cytoplasmic vesicles. In OS cells, TGFβ1 induced the secretion of CatK, which degraded bone‐derived type I collagen in vitro. CatK concentrations were higher in dogs with OS than healthy dogs (11.3 ± 5.2 pmol/L versus 8.1 ± 5.0 pmol/L, P = .03). In a subset of dogs with OS, pretreatment CatK concentrations gradually decreased after palliative radiation and antiresorptive treatment, from 9.3 ± 3.2 pmol/L to 5.0 ± 3.1 pmol/L, P = .03.

Conclusions and Clinical Importance

Canine OS is associated with pathologic bone resorption, and CatK inhibitors might aid in the management of canine OS‐related malignant osteolysis.
The influence of mare numbers, ejaculation frequency and month on the fertility of Thoroughbred stallions
Authors: ALLEN W. R. , WILSHER S.
Published: December 2011

Reason for performing the study: Although considerable variation in per cycle pregnancy rates exists between Thoroughbred (TB) stallions, there is little information on factors that may influence this figure.

Objective: To assess the influence of month, mare numbers and mating frequency on the fertility of TB stallions standing on studfarms in East Anglia, England.

Methods: The daily breeding records of 31 TB stallions mating 3034 mares on 4851 occasions during the 2010 season were surveyed and related to first scan pregnancy rates. The influences of mare book size, month, number of matings per day and mating frequency or abstinence on per mating pregnancy rates were analysed.

Results: The overall per mating pregnancy rate for all the stallions was 59.6%, but for individual stallions the figures ranged from 19.0% to 80.1%. The first mating occurred on 9 February and the last on 24 July and the per mating pregnancy rate per month was significantly reduced in June and July. The number of mares mated by individual stallions ranged from 15 to 161, giving a mean overall workload of 160 matings per 100 mares. The per mating pregnancy rate was not related to book size, the number of matings in the season or the mating frequency per day. However, some stallions showed differences in per mating pregnancy rate related to month or the number of ejaculations in the preceding 3 days.

Conclusions: The majority of TB stallions are able to maintain good fertility despite large books of mares. However, 5 of the 31 stallions surveyed showed a per mating pregnancy rate of ≤50%.

Potential relevance: This survey has identified wide differences between the per mating pregnancy rate in TB stallions. Identification of the factors involved through more comprehensive surveys would provide useful information for mare and stallion owners.
Epilepsy in horses: Aetiological classification and predictive factors
Authors: Lacombe V. A. , Mayes M. , Mosseri S. , Reed S. M. , Fenner W. R. , Ou H. T.
Published: December 2011

Reasons for performing the study:In contrast with reports in man and small animals, a systematic classification of seizures in horses is lacking.

Objectives:The purpose of this study was to classify seizures based on their aetiology and to characterise epilepsy in 104 horses presented for seizures at the Ohio State University Veterinary Medical Center between 1988 and 2009.

Methods:In a retrospective observational study, seizures were classified by aetiology based on history, clinical observations, diagnostic investigations (e.g. electroencephalograms, cerebrospinal fluid and computed tomography imaging of the head) andpost mortemexaminations, when available. Univariate and multivariate logistic regression analyses were performed.

Results:Epilepsy (i.e. 2 or more recurrent seizures) was identified in 70% of cases, and further classified as symptomatic (i.e. structural brain pathology, 35.6% of cases), cryptogenic (i.e. unknown, 54.8% of cases) and idiopathic (i.e. suspected genetic predisposition, 2.7% of cases). Normal neurological examination on admission, the presence of seizures unprovoked by any identified factors and paroxysmal epileptiform activity on electroencephalogram recordings were all strongly (P<0.05) correlated with epilepsy on univariate analysis. For a horse with generalised seizures, the odds of having epilepsy was 7 times lower compared with a similar horse with partial seizures (P<0.05) in multivariate modelling.

Conclusions:Seizure aetiology was symptomatic or cryptogenic in most horses, whereas reactive seizures and idiopathic epilepsy were less common.

Potential relevance:This study is the first attempt to classify seizures and to characterise epilepsy in a referral‐based equine population. Predictive factors of epilepsy in horses were similar to those reported in other species and may assist the clinician with the early diagnosis of epilepsy.
TOWARD A CRITICAL BIOSOCIAL MODEL OF ECOHEALTH IN SOUTHERN AFRICA: THE HIV/AIDS AND NUTRITION INSECURITY SYNDEMIC
Authors: Singer Merrill
Published: December 2011

Increasingly, it is recognized that traditional narrow approaches to environment and health relations are insufficient to comprehend and respond effectively to the complexity of factors influencing human health. In response, a new approach, referred to as Ecohealth has emerged with the goal of assessing the multiple interactions that occur between components the ecosystem, the local and global political economy, and cultural systems, on the one hand, and the ways in which these biosocial interactions influence the nature, concentration, and entwinement of health problems in human populations, on the other. Those contributing to the development of the Ecohealth orientation also seek to identify evidence‐based strategies for improving the health and living conditions of human populations and the sustainability of the ecosystems in which they live. Within anthropology and public health, in particular, one reflection of the broader Ecohealth approach is expressed in the concept of syndemics, which was developed during the 1990s to label the various interactions among comorbid diseases and other health conditions that increase the burden of suffering in populations and the encompassing social relations and conditions that amplify the likelihood of adverse disease interactions occurring. In southern Africa, a notable synergism has developed between HIV/AIDS and food insecurity that significantly threatens the health and well‐being of diverse populations in the region. The purpose of this chapter is to examine the key epidemiological, environmental, social, and political economic features of the entwined HIV‐affected food insecurity and food insecurity‐affected HIV syndemics of southern Africa.
FOOD INSECURITY AND MATERNAL‐TO‐CHILD TRANSMISSION OF HIV AND AIDS IN SUB‐SAHARAN AFRICA
Authors: Sellen Daniel W. , Hadley Craig
Published: December 2011

It is not known to what extent food insecurity may underlie the continued high rates of maternal to child transmission of HIV and AIDS (MTCT) in sub‐Saharan Africa, where most cases of pediatric HIV and AIDS are reported to occur. However, a number of plausible conceptual models and a growing evidence base drawn from both qualitative and empirical studies suggest that food insecurity contributes significantly to the epidemic of pediatric HIV infection. Specifically, food insecurity puts women at risk of HIV infection and weakens the ability of infected women and the health systems to which they may have access to prevent secondary infection of their children. Applied anthropologists have played a role in understanding some of the pathways through which food insecurity mediates biological and social risks of maternal to child transmission of HIV and AIDS. Efforts to understand and address the biocultural pathways through which food insecurity increases transmission of HIV from mothers to children can raise awareness of the importance of food and nutrition security among policy makers and program planners. Applied research on food insecurity by anthropologists can inform communities and contribute to the design of improved programs to prevent of MTCT.
“TWELVE YEARS ON”: THE IMPACTS OF HIV AND AIDS ON LIVELIHOODS IN ZAMBIA
Authors: Samuels Fiona , Drinkwater Michael
Published: December 2011

In 1993 a study looking at the impacts of HIV and AIDS on livelihoods was conducted in two districts in Zambia—Mpongwe and Teta. Twelve years later in 2005 a restudy of the same areas was undertaken. The aim was to understand what had happened to individuals and clusters in the intervening period in terms of their adaptability and resilience to HIV and AIDS, and to assess whether the “cluster,” or livelihood network methodology was an effective approach to explore the impact of AIDS on farming, livelihoods, and social change. Significant changes had occurred at meso and national levels; Mpongwe had become a district capital, agricultural subsidies had been removed, health services had been decentralized and ART was becoming more available. As predicted by the first study, in 2005 Mpongwe was experiencing the full‐blown impact of AIDS. However, the most significant finding of the study, which the livelihoods network methodology helped to highlight, was how social units had adapted and how livelihoods had remained surprisingly resilient. In Teta, AIDS impacts had been much less and a shift back to more traditional farming systems was seen. Because the future holds an inevitable increase in shocks and stresses, with now climate change too, the study highlights the need for more creative and informed approaches for buttressing the social protection functions of livelihood networks.
Improvement of Geometric Accuracy in Incremental Forming by Using a Squeezing Toolpath Strategy With Two Forming Tools
Authors: Malhotra Rajiv , Cao Jian , Ren Feng , Kiridena Vijitha , Cedric Xia Z. , Reddy N. V.
Published: December 2011

Single point incremental forming (SPIF) is plagued by an unavoidable and unintended bending in the region of the sheet between the current tool position and the fixture. The effect is a deformation of the region of the sheet in between the formed area and the fixture as well as deformation of the already formed portion of the wall, leading to significant geometric inaccuracy in SPIF. Double sided incremental forming (DSIF) uses two tools, one on each side of the sheet to form the sheet into the desired shape. This work explores the capabilities of DSIF in terms of improving the geometric accuracy as compared to SPIF by using a novel toolpath strategy in which the sheet is locally squeezed between the two tools. Experiments and simulations are performed to show that this strategy can improve the geometric accuracy of the component significantly by causing the deformation to be stabilized into a local region around the contact point of the forming tool. At the same time an examination of the forming forces indicates that after a certain amount of deformation by using this strategy a loss of contact occurs between the bottom tool and the sheet. The effects of this loss of contact of the bottom tool on the geometric accuracy and potential strategies, in order to avoid this loss of contact, are also discussed.