bluuebunny/crossref_metadata_2025 huggingface dataset:
Bleb needling outcomes for failed trabeculectomy blebs in Asian eyes: a 2 year follow up
Authors: TSAI A , BOEY PY , HTOON HM , WONG TT
Published: August 2014

Purpose To describe the outcomes and success rates of bleb needling in primary angle closure glaucoma (PACG), primary open angle glaucoma (POAG) and secondary glaucoma.

Methods Retrospective review of 270 patients who underwent bleb needling over a 2 year period. Complete success was defined as intraocular pressure (IOP) >= 6mmHg and =< 21mmHg, in absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications.

Results 207 eyes completed the two year follow up. 84% was primary glaucomas and 16% was secondary glaucomas. The mean interval between filtering surgery and bleb needling was 8.4(SD 17.2) months. The mean IOP pre‐needling was 21 (SD7.2) and there was a statistically significant reduction of IOP of at least 22% from month 1 through to month 24. The complete success rates at month 6 for POAG, PACG and secondary glaucoma are 70%, 66% and 49% respectively, 62%, 62% and 51% at month 12, and 58%, 63% and 38% at month 24. The qualified success rates at month 6 for POAG, PACG and secondary glaucoma 24%, 30% and 29% respectively, 32%, 29% and 36% at month 12, and 35%, 30% and 53% at month 24. Logistic regression analysis showed that at month 6, POAG and PACG had a greater needling success compared to secondary glaucoma (OR 4.3.and 6.0 respectively; p < 0.05). However, at month 12 and 24 the difference in success rates was not statistically significant.

Conclusion Bleb needling within one year of trabeculectomy in Asian eyes can provide clinically significant IOP lowering of >22% for 2 years. Eyes with primary glaucomas had a greater success. Asian eyes have a greater propensity for scarring but timely bleb needling can rescue bleb function.
Serial changes in the bleb wall after glaucoma drainage implant surgery: Characteristics during the hypertensive phase
Authors: JUNG KI
Published: August 2014

Purpose To investigate serial changes in the bleb wall using anterior segment‐optical coherence tomography (AS‐OCT) in patients who had undergone Ahmed glaucoma valve (AGV) implantation

Methods A total of 52 patients who had undergone AGV implantation were enrolled. Reflectivity and mean thickness of the bleb wall were examined using AS‐OCT at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. Intraocular pressure (IOP) and the number of glaucoma medications was evaluated. The hypertensive phase was defined as IOP > 21 mmHg during the first 3 months after surgery. Patients were divided into two groups: hypertensive and non‐hypertensive groups.

Results Following AGV implantation, IOP decreased at each time point during postoperative follow‐up (P value < 0.001, all) with a peak in the first month. Mean bleb wall thickness showed a U‐shaped curve postoperatively, being thinnest 1 month after the operation. Reflectivity showed an inverted U‐shaped curve postoperatively, being brightest 1 month after the operation. A hypertensive phase was observed in 44 patients (84.6%). The bleb wall was significantly more reflective (130.67 ± 27.00 vs. 106.57 ± 10.35; P = 0.044) in the hypertensive group than in non‐hypertensive group 1 month postoperatively.

Conclusion Hypertensive phase peaked at 1 month after aqueous shunt surgery. At that time, the bleb wall had the highest reflectivity. The unique IOP pattern after tube surgery is related to fibrosis of the bleb wall qualitatively. Specific modulation of wound healing may be the target for attempts to decrease the development of hypertensive phase.
Long‐term efficacy of interferon in severe uveitis asssociated with Behçet disease
Authors: DIWO E , GUEUDRY J , WESCHLER B , SAADOUN D , LE HOANG P , BODAGHI B
Published: August 2014

Purpose We aimed to evaluate long‐term efficacy of interferon alpha 2a (IFNα2a) in severe Behçet disease(BD)‐related uveitis.

Methods Our retrospective study includes all patients with severe uveitis treated with IFNα2a for at least 18 consecutive months at Pitié Salpêtrière Hospital between 05/1995 and 07/2013. Before, during and after treatment, best corrected visual acuity (VA), ophthalmologic examination and fluorescein angiography were performed to evaluate the number of acute uveitis. The main evaluation criteria was the number of uveitis relapses per person per year before, during and after treatment.

Results 33 patients, 12W/21M, with a mean age of 30,5 years and with mainly panuveitis (74.2%) were included. The mean observation period was 8,82 years. We followed 33, 25, 20 and 18 patients for 2, 4, 7 and 9 years respectively. The relapse rate decreased from 1,36 before treatment to 0,045 relapses/patient/year during IFNα treatment. After IFNα discontinuation (possible for 64% of all patients), it increased to 0,057 relapses/patient/year and the mean period between discontinuation and relapse was 24.2 months. Average VA improved from 0,49 to 0,27 and from 0,55 to 0,39 LogMar for the patients with a followed‐up of 4 and 9 years respectively. During 4 years following IFNα2a initiation, we observed rapid decrease of anterior inflammation, hyalitis, vasculitis, macular and papillary edema. Mean oral prednisone consumption decreased from 22,8 mg at IFN initiation to 5,5 mg per day at 9 years.

Conclusion IFNα2a is efficient to treat severe BD‐related uveitis. For initial responders allowing discontinuation of IFNα2a, the long‐term remission was confirmed with our study.
Staphylococcal Panton‐Valentine leucotoxin targets retina through the ganglion cell layer in a rabbit toxin‐induced endophthalmitis model
Authors: HEITZ P , TAWK M , PRÉVOST G , GAUCHER D
Published: August 2014

Purpose Staphylococcal leucotoxins form a cluster of bi‐component leucotoxins that are associated with tissue necrosis pathologies, such as necrotising pneumonia, osteomyelitis and endophtalmitis. Among them, Panton‐Valentine leucotoxine (PVL) is often associated with strains isolated in such diseases and seems to possess acute capabilities to promote necrosis. When injected into the rabbit vitreous, these toxins were proven to induce a huge inflammatory reaction that might concern the full eyeball. The purpose of this study was to identify the PVL target cells into the retina, using a rabbit model of endophtalmitis.

Methods Three µg of LukS‐PV were injected in a series of rabbit eyes. After 1 hour, the eyes were enucleated. Frozen sections were prepared for immunofluorescence detection tests. PVL was immunolabelled using a specific antibody and a secondary fluorescent antibody. Co‐labelling with GFAP (Muller cells), RBPMS (ganglion cells), ChAT (starbust displaced amacrine cells) antibodies were realized. Left eyes were used as negative controls.

Results LukS‐PV was present at the ganglion cells layer. A few dendrites in the inner plexiform layer were also noted. Co‐labeling experiments with the specific marker ChAT (acetylcholin transferase) segregated starbust displaced amacrine cells as a retinal target of LukS‐PV. 65% of the infected cells were ChAT positive.

Conclusion At least, one retinal cell type, i.e. Starbust amacrine cells, can now be designated as a target of PVL and it will be important to explore how this cell fitness is sensitive to such a toxin compared with the activation of polymorphonuclear cells, and neurons that also were reported as possible targets.
Funcionality characterization of RS2229094 (T>C) polymorphism and LT[Alpha] expression in human retinas
Authors: DELGADO TIRADO S , PASTOR IDOATE S , RODRIGUEZ HERNANDEZ I , ROJAS J , GONZALEZ BUENDIA L , GONZALEZ SARMIENTO R , PASTOR JC
Published: August 2014

Purpose To determine the expression and localization of lymphotoxin alpha (LTα) in human retinas, and investigate the functionality of the LTα rs2229094 (T>C) polymorphism, previously associated to proliferative vitreoretinopathy (PVR) development.

Methods Phase I: RNA from 3 healthy human retinas and 2 peripheral blood samples was subjected to reverse transcription polymerase chain reaction (RT‐PCR) analysis. In addition, 3 human eyes with chronic retinal detachment (RD) and one healthy control were subjected to immunohistochemistry (IHC) with specific antibody against LTα. Phase II: Functionality of T and C alleles was assessed by using pCEFL‐Flag expression vector, and transient transfection assays. Besides, expression analysis by RT‐PCR, Western‐blot and subcellular localization of both alleles, by immunofluorescence (IF) assay were performed.

Results Phase I: Signals of mRNA LTα below significance levels were detected in healthy human retinas. Peripheral blood analysis showed different LTα transcripts with premature stop codons. IHC staining revealed no differences between human healthy and RD retinas. Phase II: No differences in mRNA and protein expression levels and subcellular localization between both alleles were found. Both alelles showed cytoplasmic LTα localization.

Conclusion Although results suggest lack of functionality, and it appears to be no differences regarding LTα expression and localization, this polymorphism could remain as a valid biomarker to identify patients at high‐risk for developing PVR after RD, due to the strong association between PVR and LTα rs2229094 polymorphism previously identified by our group.
Epidemiology of age‐related‐macular‐degeneration in north of France
Authors: DURIEUX P , DELEMOTTE A , LABREUCHE J , ROULAND J , LABALETTE P
Published: August 2014

Purpose As the leading cause of blindness in industrialized countries, AMD is an increasing public health problem. An early detection is important to provide prevention or treatment. The aim of our study was to estimate the prevalence of AMD in the North of France by a mass screening facility with a non‐mydriatic retinal camera, and to identify risk factors of the disease.

Methods This is an epidemiological study performed in the North French department for a period of 6 months. Fundus photographs of both eyes were taken in a population aged 65 years and older with no known history of AMD. Images were analyzed by two independent readers in our Department for grading pictures along to the AREDS classification. Each participant answered a questionnaire about their medical and family history, and alcohol and tobacco, fruit, vegetables, and fish consumption respectively.

Results Photographs from 2,240 eyes of 1,130 participants were analyzed. The average age in the cohort was 75 years. 13% of pictures were ungradable. 68.88 % of patients were assessed in category 1, 9.56 % in category 2, 1.44 % in category 3, and 5.56 % in category 4 (exudative or atrophic), respectively. Age was significantly associated with the disease (p<0.0001), fruits and vegetables consumption was a significant protective factor (p=0.002).

Conclusion The prevalence of AMD is found similar than in the EUREYE epidemiological study (8% of AMD after 50 years old, more than 30% after 75 years old). In our cohort, the overall prevalence of AMD is 24% in the population over 65 years old. Nonmydriatic fundus photography is a simple, fast, non‐invasive and reliable AMD‐detecting technique that can be performed by nonphysicians then teletransfered to an ophthalmologist for reading.
ADVISE (ADenoVirus Initiative Study in Epidemiology)
Authors: DUQUESROIX B , TUIL E , MESSMER EM
Published: August 2014

Purpose ADVISE is an epidemiological, prospective, multicentric, open study to assess the characteristics and frequency of adenoviral conjunctivitis (AC) as diagnosed with the point of care AdenoPlus® test in patients suffering from acute conjunctivitis in 5 EU countries (F, It, Ger, UK, Sp).

Methods Bacterial or viral conjunctivitis are usually self‐limiting but some viral cases may cause persistent disease and significant morbidity. AC causes more severe disease, is extremely contagious (transmission rate 10‐50%), of longer duration than bacterial (shed for 14‐16 days, signs and symptoms last 2‐3 weeks) and may lead to decreased visual acuity or light sensitivity from persistent subepithelial infiltrates, chronic dry eye, and visual loss from conjunctival scarring.

Results AdenoPlus® is a single use, rapid (10 min.) immunoassay test for the qualitative in‐vitro detection of Adenoviral hexon protein antigens directly from human eye fluid. It is a CE marked, point‐of‐care medical device intended for health professional use as an aid in the rapid differential diagnosis of acute conjunctivitis. Study objectives are to assess the % of patients with acute conjunctivitis who have AC, the clinical profiles associated with positive and negative tests, the correlation between the initial clinical diagnosis and the final diagnosis (post‐test), the AC seasonality and geographic distribution, and to collect pharmacoeconomic data (before/after test prescribed treatments, work/school absenteeism…).

Conclusion Enrollment started in June 2013 in France and in January 2014 in Germany. Italian, Spanish and UK sites will start recruiting Q2‐Q3/2014. Approximately 2500 patients are expected across EU, 500 patients from 15‐20 sites per country (20‐30 patients per site). The first interim study results will be presented with data analyses from at least 400 patients recruited in EU.
Novel and known FRMD7 mutations and copy number variation in Belgian patients with X‐linked idiopathic infantile nystagmus
Authors: ALMOALLEM B , BAUWENS M , WALRAEDT S , DELBEKE P , VERDIN H , VAN CAUWENBERGH C , DE LEENEER K , HOOGHE S , KESTELYN P , AL‐OBEIDAN S , DE ZAEYTIJD J , LEROY BP , DE BAERE E
Published: August 2014

Purpose Idiopathic Infantile Nystagmus (IIN [MIM# 310700]) is one of the commonest forms of infantile nystagmus characterized by bilateral uncontrollable eye movements that does not manifest until the child starts to fixate objects at the age of three months leading to low visual acuity scores. Genetically IIN is a heterogeneous disorder which is mostly inherited in an X‐linked fashion. There are three known loci and two identified genes. Approximately 50% of families with X‐linked IIN have been shown to be linked to mutations in the FERM domain‐containing protein 7 (FRMD7) gene. Thus far 45 unique mutations have been reported in FRMD7 related patients with IIN. We investigate the role of FRMD7 mutations and copy number variations in Belgian cohort of 49 unrelated families with a clinical diagnosis of IIN.

Methods Forty‐nine families underwent detailed ophthalmological examinations and DNA extraction. We set up a comprehensive molecular genetic test based on Sanger sequencing, targeted next generation sequencing (NGS) and copy number variation (CNV) analysis. The reference sequence used was NM_194277.2.

Results In eleven unrelated Belgian families with IIN, seven unique FRMD7 changes were found, five of which are novel: frameshift mutation c.2036del p.(Leu679Argfs*8), missense mutations c.801C>A p.(Phe267Leu) and c.875T>C p.( Leu292Pro), splice site mutation c.497+5G>A and one CNV (1.4 Mb deletion). .Additionally, four known mutations were found: missense mutations c.70G>A p.(Gly24Arg) and c.886G>C p.(Gly296Arg), nonsense mutation c.910C>T p.(Arg303*); frameshift mutations c.2036del p.(Leu679Argfs*8) and c.660del p.(Asn221Ilefs*11) which were found in a three independent families. Haplotype reconstruction suggests a potential founder effect in Belgian IIN patients. Segregation testing of these mutations was performed and supports their pathogenic effect.

Conclusion Overall, we found both coding FRMD7 mutations and a CNV in 11/49 Belgian families with IIN (22%) and expand the mutational spectrum of FRMD7 as a common cause of IIN. Finally, our study generates a discovery cohort of IIN patients harboring either undetected mutations in non‐coding region of FRMD7 or in genes at known or novel loci sustaining the genetic heterogeneity of the disease.
Change of ocular components after cycloplegia in children using the IOLMaster
Authors: CHANG HR , JANG HJ
Published: August 2014

Purpose Ocular components are traditionally measured using A‐scan ultrasound. With ultrasound, the probe makes contact with the cornea, so there is some problem in children. The IOLMaster is non‐contact device that can measure ocular components, so it can be used in children with poor cooperation. We evaluated change of ocular components after cycloplegia in children using the IOLMaster.

Methods One hundred and sixty eight children aged from 3 to 15 years were recruited from the Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine. Children with ocular problem except refractive error were excluded. Pre‐ and post‐cycloplegic corneal curvature (CC), anterior chamber depth (ACD) and axial length (AL) on the right eye were measured with the IOLMaster. We evaluated the change of ocular components after cycloplegia by age and refractive error.

Results ACD was 0.134 ± 0.134mm deeper after cycloplegia (p=.000). The amount of change had statistically significant negative correlation with age (Pearson correlation ‐0.332, p=.006), but it was not significantly different between myopic and hyperopic group after age correction (p=.398). AL was also significantly elongated after cycloplegia (p=.000), but the amount of change was very small (0.011 ± 0.022mm). There was no change in CC after cycloplegia (p=.428).

Conclusion Effect of cycloplegia on ACD in children measured with the IOLMaster was significant. We suppose that the negative correlation between the change of ACD and age may be associated with decreasing accommodation with age.
Fluorescein angiography in the management of ROP occurred at a late postmenstrual age: our experience on seven premature infants
Authors: GUAGLIANO R , BARILLA' D , BERTONE C , SPALLONE L , MAFFIA A , BIANCHI PE
Published: August 2014

Purpose To report author’s management with digital camera fluorescein angiography (FA) of Type 1 retinopathy of prematurity (ROP) developed after 45 weeks of postmenstrual age (PMA).

Methods Retrospective non comparative case series consisting of seven prematurely born infants with Type 1 ROP that falls outside of usual time line for the disease (PMA > 45 weeks).

Results 212 premature infants with gestational age ≤ 30 weeks underwent ROP screening between January 2009 and December 2013 at Neonatal Pathology Department at San Matteo Hospital in Pavia. ROP was found in 86 babies (172 eyes, 40%) and 28 of these (56 eyes, 20.6%) were treated with laser photocoagulation. 14 eyes of 7 children developed temporal peripheral ROP (stage 2, zone 3) between 45 and 50 weeks of PMA and were included in our study. The mean gestational age for this subgroup was 27,8 weeks and mean birth weight was 864 g. Diagnosis and management were performed with indirect ophthalmoscopy, RetCam 3 and digital video FA. In 7 eyes ROP was treated with laser fotocoagulation at 47‐48 weeks PMA, while in 7 eyes regressed spontaneously with full retinal vascularisation between 48‐54 weeks PMA.

Conclusion Although rare, Type 1 ROP may occur lately, after 45 weeks PMA. It is insidious because unexpected and located in extreme retinal periphery. In our experience, FA images were very useful to study the clinical features of ROP and to reveal us whether retinopathy was progressing towards threshold disease or regressing. Fluorescein Angiography lead our decisional choose: to perform laser treatment or go on with closely observation over time until the complete retinal peripheral vascularisation.
Susac syndrome revealed by retinal arterial occlusions in a 12 year old girl
Authors: BEAUJEUX P , CLOCHE V , TRECHOT F , ANGIOI K
Published: August 2014

Purpose Susac's syndrome (SS) is a rare immune disorder. It combines encephalopathy, retinopathy and hearing loss. We report a new pediatric case, revealed by an occlusive retinal arteritis.

Methods A 12‐year old girl came to emergency room due to sudden onset of photopsia in her right temporal visual field. One year before, she had developed an acute disseminated encephalomyelitis, resolved after steroids. Visual acuity was 10/10 P2. Fundus examination revealed a thin right inferior nasal artery associated with an ischemic oedema. Fluorescein angiography evidenced a right nasal artery occlusion and multiple peripheral arterial occlusive vasculitis. Steroid treatment was dispended. Brain MRI showed high signal‐intensity abnormalities in corpus callosum. The triad was completed by a bilateral hearing loss. Intravenous immunoglobulins were initiated. Occurrence of contralateral occlusive retinal arteritis two months later led to introduce cyclophosphamide. After 6 infusions, visual acuity is stable but visual field defects are still present and regression of vasculitis remains incomplete.

Results 300 cases of SS have been reported with predominance in young women. Pediatric cases are extremely rare. Diagnosis is difficult, because the typical clinical triad is often incomplete. Occurrence of relapses is unpredictable. Visual prognosis depends on localisation of occluded retinal territories. Treatment is based on a combination of steroids, immunosuppressive and antiplatelet agents, which is not always able to prevent the relapse as in our young patient.

Conclusion Unpredictable evolution of SS requires an early diagnosis and treatment as well as a close monitoring. It must always be considered in case of occlusive retinal arteritis even in children.
Results of the surgical treatment of concomitant strabismus with preliminary modeling of operation by using three‐dimensional biomechanical eye's model
Authors: BUSHUYEVA NN , ROMANENKO DV
Published: August 2014

Purpose Analysation of the surgical treatment results of concomitant strabismus in patients based on volume of operation preliminary modeling using three‐dimensional biomechanical eye model (TBEM "SEE‐KID")

Methods We examined the angel of strabismus by Hirschberg, with Frenel's prisms on table Maddox,binocular vision. There were analysed surgical treatment results of concomitant strabismus in 106 patients, wich were opereted after investigation preliminary modeling using three‐dimensional biomechanical eye model (TBEM "SEE‐KID").

Results Orthotropy was obtained in 54 from 106 patients (50,9%)at the first day after operation.52from 106 patients (49,1%) had residual angle of 5‐10 hypocorrection was in 44 patients, and hypocorrection was in 8 patients. 18 patients were lost to follow‐up. At 3‐12 months folliw‐ups ortothrop has been preserved in 53 from 88 patients (60,2%), and 35 from 88patients residual angle of 5‐10 remained ‐ hypocorrection was in 31 patients, and hypocorrection was in 4 patients.

Conclusion TBEM "SEE‐KID" use in complex examination and results of surgical treatment in patients with strabismus allows prognosing surgical result in 60% of cases and accelerates diagnostic process. This method needs further investigation.Particularly extraocular muscles biomechanics needs precisely estimated (degree hyper or hypofunction, movement amlitude).
Clinical features of oculomotor disorders and nystagmus among children presenting congenital glaucoma
Authors: AZIZ A , MATONTI F , SAUVAN L , FAKHOURY O , PIERI E , DENIS D
Published: August 2014

Purpose Strabismus and nystagmus are often reported in congenital glaucoma ( CG), but few data are available. This study aims at describing clinical features of oculomotor disorders associated with congenital glaucoma.

Methods A retrospective study was led in a service of Pediatric Ophthalmology of the South of France taking for reference the registers of the children operated for primitive CG between 2008 and 2013. We registered the caracteristics of cross‐eyed infringement, the nystagmus, refractive data and amblyopia. Tests of chi ² or exact tests of Fisher were used for the category‐specific variables and the tests of Mann‐Whitney for the quantitative variables.

Results 47 children were included.2 children presented an unilateral CG. 25%(12 children) presented a strabismus ;4 had a convergent deviation (33 %) and 8 an exotropia(66 %).4 children (8 % ) had a nystagmus, and all of them had a low best corrected visual acuteness(BCVA)(BCVA lower than 0,6 LogMAR). We find an average spherical equivalent (SE) more important in myopia in the cross‐eyed population (average SE ‐1.75 D) with regard to the non strabismic population (average SE ‐0.35 D). Regarding nystagmic patients, we find a much more important average SE in myopia (average SE ‐7.8 D) with regard to the non‐strabismic population (average SE ‐0.35 D)( p: 0.016). A statistically significant link exists between amblyopia and nystagmus occurency (p Fischer: 0.013).

Conclusion Most of the children taken in care for primitive CG and presenting a deviation had a visual acuteness decreased in our study. The nystagmus seems to appear for BCVA lower than 0,6 LogMAR. This amblyopia seems to have both organic origin but also refractive origin.
Microglial activation in a rat model of NAION
Authors: REMOND A , FEL A , SIMONUTTI M , IVKOVIC I , FROGER N , SAHEL J , LE HOANG P , BODAGHI B , PICAUD S , TOUITOU V
Published: August 2014

Purpose Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common optic neuropathy over 50 years and there is no treatment for this condition. Activation of retinal microglial cells (RMC) is known to contribute to retinal ganglion cell (RCG) death after optic nerve injury. The purpose of this study was to examine early microglial activation and investigate the effect of minocycline on this activation in a rat model of NAION (rNAION).

Methods We used a rNAION model to generate axonal ischemic infarct by rose Bengal dye laser photoactivation. NAION was induced in the right eye of each animals. 1 group received minocycline (22 mg/kg) intraperitoneally and the other had a sham injection of saline, 3 days before induction till sacrifice. Animals were euthanazied at day1, 3 and 7. Immunohistochemistry and quantitative stereology of RCG and RMC were performed on flat‐mounted retina. Expression levels of apoptosis‐related genes (Bax, caspase 3), inflammation related genes (IL‐1β, TNFα), and vascular growth factor related genes (VEGF‐a, VEGF‐R1, VEGF‐R2) were measured by qPCR.

Results Microglia was activated early in the course of NAION. Quantitative analyses showed that the RMC number was increased in the right eye at day 1, 3, and 7 in both groups. Animals untreated tend to have increased activated RMC compared to controls (p>0.05). Minocycline also modulates proinflammatory cytokines expression, and caspase 3 activation.

Conclusion Our results suggest that microglial activation contribute to retinal ganglion cell death after NAION. Minocycline may promote RGC survival by microglial inhibition.
The application of Colour Contrast Sensitivity test to the early prediction of chiasm damage in cases of pituitary adenoma
Authors: KRIAUCIUNIENE L , SLATKEVICIENE G , LIUTKEVICIENE R , ZALIUNIENE D , BERNOTAS G , GLEBAUSKIENE B , TAMASAUSKAS A
Published: August 2014

Purpose Our objective was to estimate the maximum colour contrast sensitivity (MCCS) thresholds in persons with damage of chiasma opticum.

Methods Forty one persons with pituitary adenoma (PA) and 100 persons as age and gender matched controls were examined. Patients were divided into groups: according to who had chiasmal compression on imaging and who had not. A new computerized MCSS test program was used for colour discrimination.

Results The mean of error score (ES) of MCCS in the group without chiasmal compression was 1.8 [SD, 0.38], in the group with chiasmal compression it was 3.5 [SD, 0.96], and in the control group it was 1.4 [SD, 0.31], (P<0.001). When visual acuity and visual field and fundus were normal in patients with PA, MCCS ES were 3.3 [SD, 1.8], and when VA was less than 1.0 the results were – 4.6 [SD, 2.9].

Conclusion Results of MCSS test ES were 1.9 times better in patients who had not chiasmal compression compared to patients who had chiasmal compression (P<0.001). Even when VA was normal in PA patients group, their ES was 2.35 times worse compared to healthy persons, P<0.001. Financial support: Lithuanian Science Council (grant no. MIP‐008/2014).
Sudden bilateral vision loss and binasal campimetric involvement in an unusual case of lateral geniculate myelinolysis
Authors: JIMENEZ DEL RIO B , PALACIN M , PÉREZ D , ASCASO FJ
Published: August 2014

Purpose Central pontine myelinolysis, a devastating demyelinating disease, is thought to be caused by an aggressive correction of a hyper‐ or hypo‐osmolar state. Lateral geniculate nucleus (LGN) has been incidentally found to be affected by an extrapontine demyelination on magnetic resonance imaging (MRI), although visual disturbances implicating both LGNs are unusual. We describe a campimetric involvement secondary to an intrageniculate damage.

Methods A 40‐year‐old man, who was diagnosed with pancreatitis following cholecystectomy, complained of bilateral acute vision loss. His best corrected visual acuity (BCVA) was counting fingers in the right eye and 20/200 in the left eye. Optical coherence tomography (OCT) showed a slightly increased macular thickness in the nasal region of both eyes as well as an altered reflectivity of the retinal layers. Automated perimetry revealed a binasal hemianopsia and brain MRI confirmed symmetrical lesions within both LGNs. BCVA was gradually recovered, reaching 20/20 within 6 weeks.

Results Lateral geniculate myelinolysis is an uncommon cause of acute bilateral vision loss which might cause retinal alterations by a retrograde way. Although MRI is the optimal imaging technique to confirm the diagnosis, OCT and visual field examination are able to detect subtle changes.

Conclusion Binasal hemianopsia from intrageniculate myelinolysis has been described after rapid changes in serum sodium, following an emergency caesarean section or secondary to anaphylactic shock. To the best of our knowledge, this is the first case reported where it was induced by fluid and electrolyte imbalance in an acute pancreatitis.
Optic neuropathy caused by type A botulinic toxin
Authors: MORREALE BUBELLA R , VADALA M , MORREALE BUBELLA D
Published: August 2014

Purpose To report the development of an optical neuropathy after injection of type A botulinic toxin in a subject with blepharospasm.

Methods Optical neuropathy was evaluated through a complete ophthalmologic examination consisting of bio‐microscopy, tonometry and study of visual sharpness, colour test, visual field, OCT, fluorangiography and determination of VEPs.

Results Intravenous therapy was begun with Metilprednisolone (20 mg/Kg/day) and Vitamin B6 associated with oral Citicoline, and there was a clear improvement down to normalization of the symptoms. After 6 months the Humphrey computerized visual field with central 30‐2 program threshold test emphasised in ODx an upper half‐field arc‐shaped defect starting from the optical papilla and also affecting the fixation zone, while for the left eye the perimeter picture was always normal. Optical coherence tomography (OCT) examination of the peripapillary nervous fibres and of the head of the optical nerve highlighted a reduction in thickness of the papillary fibres with a rim area of 0.011 compared to the contralateral side, which presented a normal thickness of the fibres and a rim area of 0.026. The colour test was normal and the speed of execution of the test proved to be equal in the two eyes.

Conclusion The authors draw attention to the need for correct administration of the botulinic toxin in the treatment of blepharospasm.
Telocytes subtypes in human urinary bladder
Authors: Vannucchi Maria‐Giuliana , Traini Chiara , Guasti Daniele , Giulio Del Popolo , Faussone‐Pellegrini Maria‐Simonetta
Published: August 2014

Urinary bladder voiding is a complex mechanism depending upon interplay among detrusor, urothelium, sensory and motor neurons and connective tissue cells. The identity of some of the latter cells is still controversial. We presently attempted to clarify their phenotype(s) in the human urinary bladder by transmission electron microscopy (TEM) and immunohistochemistry. At this latter aim, we used CD34, PDGFRα, αSMA, c‐Kit and calreticulin antibodies. Both, TEM and immunohistochemistry, showed cells that, sharing several telocyte (TC) characteristics, we identified as TC; these cells, however, differed from each other in some ultrastructural features and immunolabelling according to their location. PDGFRα/calret‐positive, CD34/c‐Kit‐negative TC were located in the sub‐urothelium and distinct in two subtypes whether, similarly to myofibroblasts, they were αSMA‐positive and had attachment plaques. The sub‐urothelial TC formed a mixed network with myofibroblasts and were close to numerous nerve endings, many of which nNOS‐positive. A third TC subtype, PDGFRα/αSMA/c‐Kit‐negative, CD34/calret‐positive, ultrastructurally typical, was located in the submucosa and detrusor. Briefly, in the human bladder, we found three TC subtypes. Each subtype likely forms a network building a 3‐D scaffold able to follow the bladder wall distension and relaxation and avoiding anomalous wall deformation. The TC located in the sub‐urothelium, a region considered a sort of sensory system for the micturition reflex, as forming a network with myofibroblasts, possessing specialized junctions with extracellular matrix and being close to nerve endings, might have a role in bladder reflexes. In conclusions, the urinary bladder contains peculiar TC able to adapt their morphology to the organ activity.
To fast or feed: an alternative life history for anadromous brook trout Salvelinus fontinalis overwintering within a harbour
Authors: Spares A. D. , Dadswell M. J. , MacMillan J. , Madden R. , O'Dor R. K. , Stokesbury M. J. W.
Published: August 2014

The seasonal feeding pattern of sea‐run brook trout Salvelinus fontinalis was studied from November to May 2010–2012 in Antigonish Harbour, Nova Scotia, Canada (45° 38′ N; 61° 55′ W). Sixty‐three S. fontinalis (mean ± s.d. fork length = 330 ± 70 mm and mass = 536 ± 351 g) captured had fed predominantly on fishes (Fundulidae and Gasterosteidae). Percentage of empty stomachs was highest during autumn (18%) and winter (22%) and lowest in spring (7%). Stomach fullness increased from autumn to a maximum during winter, relating to near‐zero body temperatures which may have effectively stopped gastric evacuation. Although feeding occurred during winter (December to March), consumption rates were calculated as negative values, and subsequently returned to positive values in spring (April to May). The over‐winter life‐history strategy of this sea‐run S. fontinalis population appears to be a feeding marine migration in which fish continually increase body condition, representing an alternative to the more common overwintering strategy of starvation in fresh water until spring.
Simulation: A New Approach to Teaching Ethics
Authors: Buxton Margaret , Phillippi Julia C. , Collins Michelle R.
Published: August 2014

The importance of ethical conduct in health care was acknowledged as early as the fifth century in the Hippocratic Oath and continues to be an essential element of clinical practice. Providers face ethical dilemmas that are complex and unfold over time, testing both practitioners’ knowledge and communication skills. Students learning to be health care providers need to develop the knowledge and skills necessary to negotiate complex situations involving ethical conflict. Simulation has been shown to be an effective learning environment for students to learn and practice complex and overlapping skills sets. However, there is little guidance in the literature on constructing effective simulation environments to assist students in applying ethical concepts. This article describes realistic simulations with trained, standardized patients that present ethical problems to graduate‐level nurse‐midwifery students. Student interactions with the standardized patients were monitored by faculty and peers, and group debriefing was used to help explore students’ emotions and reactions. Student feedback postsimulation was exceedingly positive. This simulation could be easily adapted for use by health care education programs to assist students in developing competency with ethics.
The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia
Authors: Vleeming A. , Schuenke M. D. , Danneels L. , Willard F. H.
Published: August 2014

The thoracolumbar fascia (TLF) consists of aponeurotic and fascial layers that interweave the paraspinal and abdominal muscles into a complex matrix stabilizing the lumbosacral spine. To better understand low back pain, it is essential to appreciate how these muscles cooperate to influence lumbopelvic stability. This study tested the following hypotheses: (i) pressure within the TLF's paraspinal muscular compartment (PMC) alters load transfer between the TLF's posterior and middle layers (PLF and MLF); and (ii) with increased tension of the common tendon of the transversus abdominis (CTrA) and internal oblique muscles and incremental PMC pressure, fascial tension is primarily transferred to the PLF. In cadaveric axial sections, paraspinal muscles were replaced with inflatable tubes to simulate paraspinal muscle contraction. At each inflation increment, tension was created in the CTrA to simulate contraction of the deep abdominal muscles. Fluoroscopic images and load cells captured changes in the size, shape and tension of the PMC due to inflation, with and without tension to the CTrA. In the absence of PMC pressure, increasing tension on the CTrA resulted in anterior and lateral movement of the PMC. PMC inflation in the absence of tension to the CTrA resulted in a small increase in the PMC perimeter and a larger posterior displacement. Combining PMC inflation and tension to the CTrA resulted in an incremental increase in PLF tension without significantly altering tension in the MLF. Paraspinal muscle contraction leads to posterior displacement of the PLF. When expansion is combined with abdominal muscle contraction, the CTrA and internal oblique transfers tension almost exclusively to the PLF, thereby girdling the paraspinal muscles. The lateral border of the PMC is restrained from displacement to maintain integrity. Posterior movement of the PMC represents an increase of the PLF extension moment arm. Dysfunctional paraspinal muscles would reduce the posterior displacement of the PLF and increase the compliance of the lateral border. The resulting change in PMC geometry could diminish any effects of increased tension of the CTrA. This study reveals a co‐dependent mechanism involving balanced tension between deep abdominal and lumbar spinal muscles, which are linked through the aponeurotic components of the TLF. This implies the existence of a point of equal tension between the paraspinal muscles and the transversus abdominis and internal oblique muscles, acting through the CTrA.
Motivational Basis of Personality Traits: A Meta‐Analysis of Value‐Personality Correlations
Authors: Fischer Ronald , Boer Diana
Published: August 2014

We investigated the relationships between personality traits and basic value dimensions. Furthermore, we developed novel country‐level hypotheses predicting that contextual threat moderates value‐personality trait relationships. We conducted a three‐level v‐known meta‐analysis of correlations between Big Five traits and Schwartz's (1992) 10 values involving 9,935 participants from 14 countries. Variations in contextual threat (measured as resource threat, ecological threat, and restrictive social institutions) were used as country‐level moderator variables. We found systematic relationships between Big Five traits and human values that varied across contexts. Overall, correlations between Openness traits and the Conservation value dimension and Agreeableness traits and the Transcendence value dimension were strongest across all samples. Correlations between values and all personality traits (except Extraversion) were weaker in contexts with greater financial, ecological, and social threats. In contrast, stronger personality‐value links are typically found in contexts with low financial and ecological threats and more democratic institutions and permissive social context. These effects explained on average more than 10% of the variability in value‐personality correlations. Our results provide strong support for systematic linkages between personality and broad value dimensions, but they also point out that these relations are shaped by contextual factors.
The Role of Poverty and Chaos in the Development of Task Persistence Among Adolescents
Authors: Fuller‐Rowell Thomas E. , Evans Gary W. , Paul Elise , Curtis David S.
Published: August 2014

Late adolescents (N = 256;Mage = 17.5) who spent a larger proportion of their early life in poverty exhibited less persistence when confronted by a challenging task. Greater chaos during early adolescence also predicted less task persistence at age 17. However, the effects of poverty were moderated by chaos such that if chaos levels were high during early adolescence, task persistence was uniformly lower among late adolescents, irrespective of childhood poverty. Only when chaos levels were relatively low did poverty matter for future task persistence. Furthermore, the interactive effects of chaos and early childhood poverty were independent of child ability, and of concurrent chaos and poverty.
Calcification of the Internal Pudendal Artery and Development of Erectile Dysfunction in Adenine-Induced Chronic Kidney Disease: A Sentinel of Systemic Vascular Changes
Authors: Maio M. Tina , McCabe Kristin M. , Pruss Cynthia M. , Pang Judith J. , Laverty Kimberly , Holden Rachel M. , Adams Michael A.
Published: August 2014

Introduction

Chronic kidney disease (CKD), erectile dysfunction (ED), and cardiovascular disease share common vascular etiologies and risk factors.

Aim

Using a rat model, this is the first study to characterize the consequences of CKD in the onset and development of ED associated with differential regional vascular calcification and circulatory changes.

Methods

Stable CKD was generated at 3 weeks in male Sprague-Dawley rats given dietary adenine and progressed until 7 weeks. Mineral content and morphometry were assessed in the internal pudendal arteries (IPAs), thoracic aorta, and carotid artery. Endothelial function was determined via changes in serum von Willebrand factor (VWF) and endothelium-dependent relaxation of the thoracic aorta.

Results

In severe CKD rats, calcium and phosphate content in all arteries increased, and pulse wave velocity was elevated. Distal IPA segments, in particular, were the first to calcify, but penile tissue per se did not. CKD rats had endothelial dysfunction, as indicated by a decrease in acetylcholine-mediated relaxation (∼40%) and an increase in serum VWF (∼40%), as well as increased lumen diameter (20%) of the distal IPA. Erectile function, assessed using a centrally acting dopaminergic agent, was significantly impaired by 7 weeks (∼40%).

Conclusions

In CKD, the distal IPA appears to be more susceptible to vascular dysfunction and calcification. Additionally, the onset of ED may be an important sentinel of impending systemic vascular disease. To confirm this concept, future experimental and clinical studies will need to examine a range of vessel types and the use of supplementary methods to assess erectile function.
Stress and land‐use legacies alter the relationship between invasive‐ and native‐ plant richness
Authors: Bart David , Davenport Tara , Carpenter Quentin
Published: August 2014

Questions

Does the driver of native richness impact invasion–diversity relationships? In high stress systems, do negative invasion–diversity relationships emerge from biotic resistance (as predicted by the diversity–resistance hypothesis) or from stress acting as a selective driver of native richness? Do invasion–diversity relationships change when abiotic and biotic legacies, rather than stress, act as non‐selective drivers of richness?

Location

Calcareous fens, Wisconsin, USA.

Methods

We compared plot‐level relationships between native and invasive species richness in 220 plots in 11 calcareous fens, six of which had stress alleviation and community impoverishment due to historic ploughing. We measured nutrient availability (resource stress) and saturation stress (non‐resource stress), native richness and invasive richness in each plot.

Results

Residual maximum likelihood (REML) regression found a negative correlation between native and invasive richness in never ploughed plots, but no relationship was found in ploughed plots. REML multiple regression found that after accounting for saturation and nutrients, there was no relationship between native and invasive richness in ploughed or never ploughed plots. Saturation stress predicted low invasive richness and high native richness in never ploughed plots. Time since abandonment did not predict invasive richness. Non‐metric multidimensional scaling (NMDS) found most invasive species present only in areas with the least saturation stress.

Conclusions

Negative relationships between native and invasive richness can result when the main driver of native richness favour native species (such as stress), and therefore may not support the diversity–resistance hypothesis. When the main driver of native richness does not select between native and invasive richness, there may be no relationship between native and invasive richness, even at very small spatial scales.
A critical domain of Sweet potato chlorotic fleck virus nucleotide‐binding protein (NaBp) for RNA silencing suppression, nuclear localization and viral pathogenesis
Authors: Deng Xing‐Guang , Peng Xing‐Ji , Zhu Feng , Chen Ying‐Juan , Zhu Tong , Qin Shao‐Bo , Xi De‐Hui , Lin Hong‐Hui
Published: August 2014

RNA silencing is an important mechanism of antiviral defence in plants. To counteract this resistance mechanism, many viruses have evolved RNA silencing suppressors. In this study, we analysed five proteins encoded by Sweet potato chlorotic fleck virus (SPCFV) for their abilities to suppress RNA silencing using a green fluorescent protein (GFP)‐based transient expression assay in Nicotiana benthamiana line 16c plants. Our results showed that a putative nucleotide‐binding protein (NaBp), but not other proteins encoded by the virus, could efficiently suppress local and systemic RNA silencing induced by either sense or double‐stranded RNA (dsRNA) molecules. Deletion mutation analysis of NaBp demonstrated that the basic motif (an arginine‐rich region) was critical for its RNA silencing suppression activity. Using confocal laser scanning microscopy imaging of transfected protoplasts expressing NaBp fused to GFP, we showed that NaBp accumulated predominantly in the nucleus. Mutational analysis of NaBp demonstrated that the basic motif represented part of the nuclear localization signal. In addition, we demonstrated that the basic motif in NaBp was a pathogenicity determinant in the Potato virus X (PVX) heterogeneous system. Overall, our results demonstrate that the basic motif of SPCFV NaBp plays a critical role in RNA silencing suppression, nuclear localization and viral pathogenesis.